Tactile sensing device for lumbar punctures

ABSTRACT

Tactile sensing devices, systems, and methods to image a target tissue location are disclosed. When force is applied to the tactile sensing device, voltage data is detected and visualized on a screen, indicating the target tissue location.

CROSS-REFERENCE

This application is a continuation of U.S. application. Ser. No.15/927,664, filed Mar. 21, 2018, which is a continuation of U.S.application Ser. No. 15/584,875, filed on May 2, 2017, which claims thebenefit of priority to U.S. Provisional Application 62/331,279, filed onMay 3, 2016, and U.S. Provisional Application No. 62/484,354, filed Apr.11, 2017, each of which are incorporated herein by reference in theirentireties.

SUMMARY

Disclosed herein, in certain embodiments, are tactile sensing devices,systems, methods, and kits for imaging bone and non-bone structures inan individual in need thereof. In certain embodiments, also describedherein are methods for performing a lumbar puncture utilizing thetactile sensing device. In certain embodiments, also described hereinare methods for administering a therapeutic to an epidural space of anindividual utilizing the tactile sensing device.

Accessing the epidural or subarachnoid space via a lumbar puncture is atechnically challenging procedure that is performed quite commonly inthe clinic, especially in the Emergency Room. The procedure involves“blindly” landmarking, or landmarking by manually palpating, the lumbarspine, to identify a gap between two spinous processes through which aneedle can be inserted into the epidural or subarachnoid space for fluidcollection or injection. The “blind” landmarking technique improves withtime and practice therefore, physicians with limited experience find thelumbar puncture procedure challenging. Furthermore, regardless ofexperience, the lumbar puncture procedure becomes difficult to performwith obese patients or patients with a high body mass index (BMI)because their high accumulation of subcutaneous adipose tissue preventsthe physician to accurately landmark the lumbar spine via manualpalpation. Current landmarking techniques only have a 30% accuracy,making it necessary for an average of >4 attempts to properly puncturethe space, and resulting in >25% of patients having traumatic lumbarpunctures and >32% of patients left with post-dural puncture headaches(PDPHs). Additionally, elderly patients or pregnant patients havelimited flexibility and are unable to maximally flex the hips, knees,and back, as is required during a lumbar puncture procedure in order toincrease the opening space between the intervertebral disks. Beyond justlandmarking and localization, other functional steps of performing adiagnostic lumbar puncture, where cerebrospinal fluid (CSF) samples arecollected and intracranial pressure is measured, are severelyinefficient. In order to obtain an intracranial pressure reading,physicians use a two-piece manometer connected to a needle hub by athree-way stopcock, which requires estimation of fluid levels indetermining intracranial pressure. To simultaneously balance a manometerand one or more cerebrospinal fluid collection tubes requiressignificant dexterity and/or sometimes more than one pair of hands.Thus, the risk of CSF spillages is high and further increases the riskof contamination. Accordingly, there is a need for improved devices,methods, systems, and kits to perform a lumbar puncture. There is also aneed for improved devices, methods, systems and kits to visualize boneand non-bone structures. In view of these deficiencies in the currentstate of the art, the subject matter presented herein addresses theseand other needs.

Disclosed herein, in certain embodiments, are tactile sensing devicesfor imaging a target tissue location in an individual in need thereof,comprising: a) a needle guide having a proximal opening and a distalopening, configured for guiding a needle towards the individual; and b)a sensor array comprising at least one sensor configured to detectapplied pressure.

Disclosed herein, in certain embodiments, are tactile sensing devicesfor imaging a target tissue location in an individual in need thereof,comprising: a) a needle guide cartridge comprising at least two needleguides, wherein each needle guide has a side opening and a distalopening, and each needle guide is configured for guiding a needletowards the individual; and b) a sensor array comprising at least onesensor configured to detect applied pressure.

Disclosed herein, in certain embodiments, are tactile sensing devicesfor imaging a target tissue location in an individual in need thereof,comprising: a) a sensor array comprising at least one sensor configuredto detect applied pressure; b) a display screen; and c) a marking toolto mark the target tissue location.

Disclosed herein, in certain embodiments, are tactile sensing devicesfor imaging a target tissue location in an individual in need thereof,comprising: a) a sensor array comprising at least one sensor configuredto detect applied pressure; b) a connection to a display screen; and c)a marking tool to mark the target tissue location.

In some embodiments, the needle guide cartridge allows for the needle tobe inserted into the individual at more than one level. In someembodiments, the needle guide allows for the needle to be inserted intothe individual at more than one angle. In some embodiments, the angle isa cephalad angle between about −45 degrees to about 45 degrees. In someembodiments, the angle is a 15 degree cephalad angle. In someembodiments, the sensor array is configured to be loaded into a sensorarray holder. In some embodiments, the tactile sensing devices furthercomprise a frame. In some embodiments, the frame further comprises anelongated portion carrying the needle guide, a downwardly elbowedportion serving as a handle, and a sensor array holder positioneddistally away from the handle. In some embodiments, the tactile sensingdevices further comprise a display screen positioned directly above thesensor array. In some embodiments, the display screen is configured todisplay the target tissue location and the needle to be inserted intothe individual. In some embodiments, the display screen is a computerscreen, a mobile device screen, a liquid crystal display (LCD), a thinfilm transistor liquid crystal display (TFT-LCD), or an organic lightemitting diode (OLED) display. In some embodiments, the tactile sensingdevices further comprise a needle hub connector that connects to theneedle, configured to be inserted through an opening of the needleguide. In some embodiments, the opening of the needle guide is theproximal opening of the needle guide or a knob opening of the needleguide. In some embodiments, the tactile sensing devices further comprisea knob that is coupled to a needle hub connector or extends from aneedle hub connector. In some embodiments, the knob protrudes from aside opening or a slit. In some embodiments, the tactile sensing devicesfurther comprise a valve. In some embodiments, the valve is a 3-wayvalve or a 3-way stopcock valve. In some embodiments, the valve isconfigured to be inserted through a knob opening of a needle guide. Insome embodiments, the valve is fixed onto a needle guide cartridge. Insome embodiments, the valve further comprises a needle hub connector, afluid connector, a fluid port, a pressure gauge connector, a pressuregauge port, or a combination thereof. In some embodiments, the tactilesensing devices further comprise a fluid collection system. In someembodiments, the fluid collection system is a faucet fluid collectionsystem, rail fluid collection system, diaphragm fluid collection system,or spoke fluid collection system. In some embodiments, the faucet fluidcollection system comprises at least one collection tube, a central rodextending downwardly from a frame, a faucet base extending downwardlyfrom the central rod, and a rotating handle for generating a rotationalmovement, said rotating handle coupled to the faucet base, wherein atleast one collection tube sits on the faucet base. In some embodiments,the rail fluid collection system comprises a pair of guide railsextending beneath a needle guide cartridge, said guide rails configuredto receive a sliding rail platform, said rail platform comprising atleast one opening, said opening configured to hold at least onecollection tube. In some embodiments, the diaphragm fluid collectionsystem comprises at least one collection tube, at least one diaphragm,at least one rotating band allowing the diaphragm to be opened orclosed, and a cap configured to be secured onto a first collection tube.In some embodiments, the spoke fluid collection system comprises acentral hub; at least one central hub opening located on a side surfaceof the central hub, said central hub opening configured to connect to atleast one collection tube; and a spoke connector extending outwardlyfrom a front face of the central hub. In some embodiments, the needle isa spinal needle, an epidural needle, or a biopsy needle. In someembodiments, the sensor array is a 6×3 sensor array comprising eighteensensors. In some embodiments, the sensor array is an 8×4 arraycomprising thirty two sensors. In some embodiments, the sensor array issecured onto a platform. In some embodiments, the platform comprisesprojections onto which the sensors are adhered to. In some embodiments,the projections are struts or connectors. In some embodiments, thesensor is covered with a material configured to enhance force feedback.In some embodiments, the sensor is a force-sensitive resistor. In someembodiments, the marking tool is a light, an ink, a hydrogel, ananoparticle. In some embodiments, the light is a laser light or a lightemitting diode (LED). In some embodiments, the ink is a permanent ink, agentian violent ink, a water-based ink, an oil-based in, a liquid ink,or a gel ink. In some embodiments, the hydrogel further comprises acontrast agent. In some embodiments, the nanoparticle further comprisesa contrast agent. In some embodiments, the tactile sensing devicesfurther comprise a multiplexer. In some embodiments, the tactile sensingdevices further comprise a voltage divider. In some embodiments, thetactile sensing devices further comprise a voltage source. In someembodiments, the tactile sensing devices further comprise a pressuresensor operatively connected to the tactile sensing device andconfigured to measure an intracranial pressure. In some embodiments, thepressure sensor is a piezoresistive pressure sensor, a capacitivepressure sensor, an electromagnetic pressure sensor, a piezoelectricpressure sensor, an optical pressure sensor, or a potentiometricpressure sensor.

Disclosed herein, in certain embodiments, are systems for imaging atarget tissue location in an individual in need thereof, comprising: a)a tactile sensing device; and b) a computing device comprising: i) atleast one processor operatively coupled to the tactile sensing device;ii) a memory device; and iii) a non-transitory computer readable storagemedium with a computer program including instructions executable by theprocessor causing the processor to convert a voltage signal into animage. In some embodiments, the computing device is a microcontroller.In some embodiments, the computing device further comprises a secondcomputer program including instructions executable by the processor thatcause the processor to encode the voltage signal into a first computersignal and a second computer signal. In some embodiments, the systemsfurther comprise a transmitter configured to transmit the first computersignal to the computing device. In some embodiments, the systems furthercomprise a receiver configured to receive the second computer signalfrom the tactile sensing device. In some embodiments, the first andsecond computer signals are transmitted remotely, directly, wirelessly,or via a wire. In some embodiments, the first computer signal and thesecond computer signals are wireless signals. In some embodiments, thecomputing device is a mobile device. In some embodiments, the computingdevice further comprises a third computer program including instructionsexecutable by the processor that cause the processor to calculate aprojected needle position and display it on the display screen. In someembodiments, the computing device further comprises a fourth computerprogram including instructions executable by the processor causing theprocessor to: a) determine, as a first requirement, a location of atarget tissue location detected by the tactile sensing device; and b)perform predictive analysis based on application of machine learning toapproximate the projected needle position.

Disclosed herein, in certain embodiments, are methods for imaging atarget tissue location in an individual in need thereof, comprising: a)placing a tactile sensing device on the individual; b) applying force tothe tactile sensing device against the individual; and c) viewing animage of the target tissue location, obtained from voltage signalsgenerated by the tactile sensing device, resulting from the applicationof force to the tactile sensing device against an individual, on adisplay screen.

Disclosed herein, in certain embodiments, are methods for generating animage of a target tissue location in an individual in need thereof,comprising: a) collecting a plurality of voltage signals generated by atactile sensing device, resulting from the application of force to thetactile sensing device against an individual; b) converting the voltagesignals into a mathematical array; c) rescaling the mathematical array;and d) transforming the rescaled mathematical array into the image of atarget tissue location of the individual.

In some embodiments, the target tissue location is a bone structure. Insome embodiments, the bone structure is an articular surface. In someembodiments, the articular surface is a vertebral articulation, anarticulation of a first bone of a hand with a second bone of the hand,an elbow joint, a wrist joint, an axillary articulation of a first boneof a shoulder with a second bone of the shoulder, a sternoclavicularjoint, a temporomandibular joint, a sacroiliac joint, a hip joint, aknee joint, or an articulation of a first bone of a foot with a secondbone of the foot. In some embodiments, the vertebral articulation is aspinous process. In some embodiments, the target tissue location is asubcutaneous tissue, a muscle, a ligament, an adipose tissue, a cyst, acavity, or a tumor mass. In some embodiments, placing the tactilesensing device on the individual further comprises positioning thetactile sensing device on a bone structure. In some embodiments, thebone structure is a vertebral column of an individual. In someembodiments, collecting the plurality of voltage signals furthercomprises transmitting the data via a multiplexer. In some embodiments,collecting the plurality of the voltage signals further comprisestransmitting the data via a voltage divider. In some embodiments,converting the plurality of the voltage signals comprises acquiring,processing, and transforming the plurality of voltage signals into theimage using a computer processor. In some embodiments, the image is apressure map representing the target tissue location. In someembodiments, the pressure map is overlaid on top of a structural spinalimage.

Disclosed herein, in certain embodiments, are methods for performing alumbar puncture in an individual in need thereof, comprising: a) placinga tactile sensing device on a lumbar region of the individual; b)applying force to the tactile sensing device against the lumbar region;c)

viewing an image of vertebral articulations on a display screen; whereinthe image is generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes of the individual and into asubarachnoid space; and g) collecting cerebrospinal fluid oradministering a therapeutic agent. In some embodiments, the therapeuticagent is an analgesic, an anesthetic, a chemotherapeutic agent, or acontrast agent or dye.

Disclosed herein, in certain embodiments, are methods for administeringa therapeutic agent to an epidural space of an individual in needthereof, comprising: a) placing a tactile sensing device on a lumbarregion of the individual; b) applying force to the tactile sensingdevice against the lumbar region; c) viewing an image of vertebralarticulations on a display screen; wherein the image is detected by thetactile sensing device resulting from the application of force to thetactile sensing device against the lumbar region; d) localizing twospinous processes on the image; e) identifying a gap between a firstspinous process and a second spinous process of the individual; f) usinga needle guide to insert a needle between the first and second spinousprocesses and into the epidural space of the individual; and g)injecting a therapeutic agent into the epidural space. In someembodiments, the therapeutic agent is an analgesic, an anesthetic, acontrast agent or dye, a chemotherapeutic agent, or a steroid. In someembodiments, the first spinous process is a part of L1, L2, L3, or L4lumbar vertebrae and the second spinous process is a part of L2, L3, L4,or L5 lumbar vertebrae. In some embodiments, the needle is a traumaticor an atraumatic needle. In some embodiments, the methods furthercomprise using a stylet or a catheter in conjunction with the needle.

Disclosed herein, in certain embodiments, are methods for guiding afirst individual performing a lumbar puncture on a second individual inneed thereof, comprising: a) placing a tactile sensing device on alumbar region of the individual; b) applying force to the tactilesensing device against the lumbar region; c) viewing an image ofvertebral articulations on a display screen, wherein the image isgenerated by the tactile sensing device resulting from the applicationof force to the tactile sensing device against the lumbar region; d)localizing two spinous processes on the image; e) identifying a gapbetween a first spinous process and a second spinous process of theindividual; f) using a needle guide to insert a needle between the firstand second spinous processes of the individual and into a subarachnoidspace; and g) collecting cerebrospinal fluid or administering atherapeutic agent.

Disclosed herein, in certain embodiments, are methods for guiding afirst individual administering a therapeutic agent into an epiduralspace of a second individual in need thereof, comprising: a) placing atactile sensing device on a lumbar region of the individual; b) applyingforce to the tactile sensing device against the lumbar region; c)viewing an image of vertebral articulations on a display screen, whereinthe image is generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes and into the epidural space of theindividual; and g) injecting a therapeutic agent into the epiduralspace.

Disclosed herein, in certain embodiments, are methods for imaging atarget tissue location in an individual in need thereof, comprising: a)placing a tactile sensing device on the individual; b) applying force tothe tactile sensing device against the individual; and c) viewing animage of the target tissue location, obtained from voltage signalsgenerated by the tactile sensing device, resulting from the applicationof force to the tactile sensing device against an individual, on adisplay screen.

Disclosed herein, in certain embodiments, are methods for generating animage of a target tissue location in an individual in need thereof,comprising: a) collecting a plurality of voltage signals generated by atactile sensing device, resulting from the application of force to thetactile sensing device against an individual; b) converting the voltagesignals into a mathematical array; c) rescaling the mathematical array;and d) transforming the rescaled mathematical array into the image of atarget tissue location of the individual. In some embodiments, thetarget tissue location is a bone structure. In some embodiments, thebone structure is an articular surface. In some embodiments, thearticular surface is a vertebral articulation, an articulation of afirst bone of a hand with a second bone of the hand, an elbow joint, awrist joint, an axillary articulation of a first bone of a shoulder witha second bone of the shoulder, a sternoclavicular joint, atemporomandibular joint, a sacroiliac joint, a hip joint, a knee joint,or an articulation of a first bone of a foot with a second bone of thefoot. In some embodiments, a vertebral articulation is a spinousprocess. In some embodiments, the target tissue location is asubcutaneous tissue, a muscle, a ligament, an adipose tissue, a cyst, acavity, or a tumor mass. In some embodiments, placing the tactilesensing device on the individual further comprises positioning thetactile sensing device on a bone structure. In some embodiments, thebone structure is a vertebral column of an individual. In someembodiments, the tactile sensing device comprises an array offorce-sensitive resistors. In some embodiments, the array offorce-sensitive resistors is a 6×3 array comprising eighteenforce-sensitive resistors. In some embodiments, the array offorce-sensitive resistors is an 8×4 array comprising thirty twoforce-sensitive resistors. In some embodiments, the array offorce-sensitive resistors is secured onto a platform. In someembodiments, the platform comprises projections onto which theforce-sensitive resistors are adhered to. In some embodiments, theprojections are struts or connectors. In some embodiments, theforce-sensitive resistors are covered with a material configured toenhance force feedback. In some embodiments, the material configured toenhance force feedback is a hemispherical rubber disk. In someembodiments, collecting the plurality of voltage signals furthercomprises transmitting the data via a multiplexer. In some embodiments,collecting the plurality of the voltage signals further comprisestransmitting the data via a voltage divider. In some embodiments,converting the plurality of the voltage signals comprises acquiring,processing, and transforming the plurality of voltage signals into theimage using a computer processor. In some embodiments, the image is apressure map representing the target tissue location. In someembodiments, the pressure map is overlaid on top of a structural spinalimage.

Disclosed herein, in certain embodiments, are methods for performing alumbar puncture in an individual in need thereof, comprising: a) placinga tactile sensing device on a lumbar region of the individual; b)applying force to the tactile sensing device against the lumbar region;c) viewing an image of vertebral articulations on a display screen;wherein the image is generated by the tactile sensing device resultingfrom the application of force to the tactile sensing device against thelumbar region; d) localizing two spinous processes on the image; e)identifying a gap between a first spinous process and a second spinousprocess of the individual; f) using a needle guide to insert a needlebetween the first and second spinous processes of the individual andinto a subarachnoid space; and g) collecting cerebrospinal fluid oradministering a therapeutic agent. In some embodiments, the therapeuticagent is an analgesic, an anesthetic, a chemotherapeutic agent, or acontrast agent or dye.

Disclosed herein, in certain embodiments, are methods for administeringa therapeutic agent to an epidural space of an individual in needthereof, comprising: a) placing a tactile sensing device on a lumbarregion of the individual; b) applying force to the tactile sensingdevice against the lumbar region; c) viewing an image of vertebralarticulations on a display screen; wherein the image is detected by thetactile sensing device resulting from the application of force to thetactile sensing device against the lumbar region; d) localizing twospinous processes on the image; e) identifying a gap between a firstspinous process and a second spinous process of the individual; f) usinga needle guide to insert a needle between the first and second spinousprocesses and into the epidural space of the individual; and g)injecting a therapeutic agent into the epidural space. In someembodiments, the therapeutic agent is an analgesic, an anesthetic, acontrast agent or dye, a chemotherapeutic agent, or a steroid. In someembodiments, the first spinous process is a part of L1, L2, L3, or L4lumbar vertebrae and the second spinous process is a part of L2, L3, L4,or L5 lumbar vertebrae. In some embodiments, the needle is a traumaticor an atraumatic needle. In some embodiments, the methods furthercomprise using a stylet or a catheter in conjunction with the needle. Insome embodiments, the needle guide is oriented between −45° and 45°cephalad angle and terminating at an opening located on the center ofthe tactile sensing device, thereby controlling the angle at which theneedle is inserted into a human body. In some embodiments, the openinglocated on the center of the tactile sensing device is an elongatedslit. In some embodiments, the needle guide is oriented at a 15°cephalad angle. In some embodiments, the needle guide terminates at aplurality of openings formed by an elongated slit with a plurality ofcolumns. In some embodiments, the methods further comprise using aplurality of needle guides oriented between a −45° and 45° cephaladangle and terminating at a plurality of openings located along themidline of the tactile sensing device, thereby controlling the angle atwhich the needle is inserted into a human body. In some embodiments, themethods further comprise using a plurality of needle guides oriented ata 15° cephalad angle. In some embodiments, the plurality of needleguides terminates at an opening. In some embodiments, the opening is anelongated slit.

Disclosed herein, in certain embodiments, are methods for guiding afirst individual performing a lumbar puncture on a second individual inneed thereof, comprising: a) placing a tactile sensing device on alumbar region of the individual; b) applying force to the tactilesensing device against the lumbar region; c) viewing an image ofvertebral articulations on a display screen, wherein the image isgenerated by the tactile sensing device resulting from the applicationof force to the tactile sensing device against the lumbar region; d)localizing two spinous processes on the image; e) identifying a gapbetween a first spinous process and a second spinous process of theindividual; f) using a needle guide to insert a needle between the firstand second spinous processes of the individual and into a subarachnoidspace; and g) collecting cerebrospinal fluid or administering atherapeutic agent.

Disclosed herein, in certain embodiments, are methods for guiding afirst individual administering a therapeutic agent into an epiduralspace of a second individual in need thereof, comprising: a) placing atactile sensing device on a lumbar region of the individual; b) applyingforce to the tactile sensing device against the lumbar region; c)viewing an image of vertebral articulations on a display screen, whereinthe image is generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes and into the epidural space of theindividual; and g) injecting a therapeutic agent into the epiduralspace.

Disclosed herein, in certain embodiments, are tactile sensing devicesfor imaging a target tissue location in an individual in need thereof,comprising: a needle guide having a proximal opening and a distalopening, configured for guiding a needle towards the individual; whereinsaid needle guide allows for the needle to be inserted into theindividual at about a 15° cephalad angle; a sensor array comprising atleast one sensor configured to output a signal in response to a changein force applied to its surface; and a fluid collection systempositioned within a handle, comprising at least one collection tube, acentral rod extending downwardly from a frame, a faucet base extendingdownwardly from the central rod, and a rotating handle for generatingrotational movement, said rotating handle coupled to the faucet base,wherein at least one collection tube sits on the faucet base. In someembodiments, the needle guide allows for the needle to be inserted intothe individual at a cephalad angle between about 10° and about 20°. Insome embodiments, the sensor array is configured to be loaded into asensor array holder. In some embodiments, the sensor is aforce-sensitive resistor. In some embodiments, the tactile sensingdevices further comprise a frame. In some embodiments, the frame furthercomprises an elongated portion carrying the needle guide, a downwardlyelbowed portion serving as the handle, and a sensor array holderpositioned distally away from the handle. In some embodiments, thesignal is converted to a pressure map. In some embodiments, the pressuremap represents a target tissue location in an individual. In someembodiments, the pressure map displays a position of a needle at a skinlevel and a projected position of a needle. In some embodiments, thetactile sensing devices further comprise a 3-way valve configured to beinserted through the proximal opening of the needle guide, and retainedwithin the needle guide, said 3-way valve comprising a needle hubconnector, a fluid port, and a pressure gauge connector. In someembodiments, the needle hub connector connects to the needle. In someembodiments, the fluid port is an open port through which a fluid flowsfreely. In some embodiments, the pressure gauge connector is configuredto connect to a pressure sensor. In some embodiments, the pressuresensor measures an intracranial pressure. In some embodiments, thepressure sensor is a piezoresistive pressure sensor, a capacitivepressure sensor, an electromagnetic pressure sensor, a piezoelectricpressure sensor, an optical pressure sensor, or a potentiometricpressure sensor. In some embodiments, the tactile sensing devicesfurther comprise a knob that is coupled to a needle hub connector orextends from a needle hub connector. In some embodiments, the knobprotrudes from a side opening or a slit. In some embodiments, the fluidcollection system is a faucet fluid collection system, a rail fluidcollection system, a diaphragm fluid a collection system, or a spokefluid collection system.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the subject matter disclosed herein are set forthwith particularity in the appended claims. A better understanding of thefeatures and advantages of the subject matter disclosed herein will beobtained by reference to the following detailed description that setsforth illustrative embodiments, in which the principles of the subjectmatter disclosed herein are utilized, and the accompanying drawings ofwhich:

FIGS. 1A-C illustrate a tactile sensing device with a faucet fluidcollection system. FIG. 1A shows a front view of the tactile sensingdevice 1000 with an exemplary output image displayed on its displayscreen 1032. FIG. 1B shows a cross-section view of the tactile sensingdevice 1000. FIG. 1C shows a wire frame side view of the tactile sensingdevice 1000.

FIGS. 2A-C illustrate another embodiment of a tactile sensing device2000 comprising multiple needle guides and a gripper 2004. FIG. 2A showsa side view of the tactile sensing device 2000 with an exemplary outputimage displayed on its display screen 2032. FIG. 2B shows a side view ofthe tactile sensing device 2000. FIG. 2C shows a cross-section view ofthe tactile sensing device 2000.

FIGS. 3A-B exemplify a sensor array 3008 of eighteen force-sensitiveresistors with silicon disks adhered onto them to enhance forcefeedback. FIG. 3A shows a side view of the sensor array 3008. FIG. 3Bshows a front view of the sensor array 3008.

FIG. 4 is an exemplary flowchart illustrating a method of to generate animage with the tactile sensing device.

FIG. 5 illustrates a diaphragm fluid collection system of the tactilesensing device.

FIG. 6 illustrates a top faucet fluid collection system of the tactilesensing device.

FIG. 7 illustrates a spoke fluid collection system of the tactilesensing device.

FIG. 8 illustrates a rail fluid collection system of the tactilesensing.

FIGS. 9A-B illustrate voltage signals acquired by a tactile sensingdevice utilizing an artificial lumbar vertebrae model. FIG. 9A showsvoltage values across a single sensor, when the sensor is moved in 1 cmincrements, as a function of a force applied (in units of grams). FIG.9B shows the normalized voltage of a column of 6 sensors for sixdifferent trials. A fixed and equal force was applied onto the column ofsix sensors for each trial.

FIG. 10 is an exemplary flowchart illustrating one method for generatingan image from voltage signals collected by the tactile sensing device.

FIGS. 11A-B are exemplary pressure maps generated by the tactile sensingdevice. FIG. 11A is a visual representation of underlying bony landmarksas detected and generated by the tactile sensing device. FIG. 11Billustrates a needle's position at the skin level (“original”) and itsprojected subcutaneous location on a pressure map generated by thetactile sensing device.

DETAILED DESCRIPTION

While preferred embodiments of the subject matter disclosed herein havebeen shown and described herein, it will be obvious to those skilled inthe art that such embodiments are provided by way of example only.Numerous variations, changes, and substitutions will now occur to thoseskilled in the art without departing from the subject matter disclosedherein. It should be understood that various alternatives to theembodiments of the subject matter disclosed herein may be employed inpracticing the subject matter disclosed herein. It is intended that thefollowing claims define the scope of the subject matter disclosed hereinand that methods and structures within the scope of these claims andtheir equivalents be covered thereby.

Certain Definitions

The terminology used herein is for the purpose of describing particularcases only and is not intended to be limiting. As used herein, thesingular forms “a”, “an” and “the” are intended to include the pluralforms as well, unless the context clearly indicates otherwise.Furthermore, to the extent that the terms “including”, “includes”,“having”, “has”, “with”, or variants thereof are used in either thedetailed description and/or the claims, such terms are intended to beinclusive in a manner similar to the term “comprising”.

The term “about” or “approximately” means within an acceptable errorrange for the particular value as determined by one of ordinary skill inthe art, which will depend in part on how the value is measured ordetermined, e.g., the limitations of the measurement system. In certainembodiments, the term “about” or “approximately” means within 1, 2, 3,or 4 standard deviations. In certain embodiments, the term “about” or“approximately” means within 30%, 25%, 20%, 15%, 10%, 9%, 8%, 7%, 6%,5%, 4%, 3%, 2%, 1%, 0.5%, 0.1%, or 0.05% of a given value or range. Incertain embodiments, the term “about” or “approximately” means within20.0 degrees, 15.0 degrees, 10.0 degrees, 9.0 degrees, 8.0 degrees, 7.0degrees, 6.0 degrees, 5.0 degrees, 4.0 degrees, 3.0 degrees, 2.0degrees, 1.0 degrees, 0.9 degrees, 0.8 degrees, 0.7 degrees, 0.6degrees, 0.5 degrees, 0.4 degrees, 0.3 degrees, 0.2 degrees, 0.1degrees, 0.09 degrees. 0.08 degrees, 0.07 degrees, 0.06 degrees, 0.05degrees, 0.04 degrees, 0.03 degrees, 0.02 degrees or 0.01 degrees of agiven value or range.

The terms “individual,” “patient,” or “subject” are usedinterchangeably. None of the terms require or are limited to situationcharacterized by the supervision (e.g. constant or intermittent) of ahealth care worker (e.g. a doctor, a registered nurse, a nursepractitioner, a physician's assistant, an orderly, or a hospice worker).

The terms “user,” “health care worker,” “doctor,” and “physician” areused interchangeably. These terms refer to any person that operates thedevices described herein. Additional non-liming examples of a userinclude “registered nurse,” “nurse practitioner,” and “physician'sassistant.”

The terms “intracranial pressure (ICP)” and “cerebrospinal fluid (CSF)pressure” are used interchangeably. ICP is the pressure inside a skulland thus, it is the pressure in the brain tissue and CSF.

The terms “lumbar puncture” and “spinal tap” are used interchangeablyherein.

The term “needle hub,” as used herein, refers to the hub at one end of aneedle that commonly attaches to a syringe. The shaft of the needle isan elongated, slender stem of the needle that extends from the needlehub and is beveled at the end opposite to the needle hub end.

Accessing the epidural or subarachnoid space via a lumbar puncture is atechnically challenging procedure that is performed quite commonly inthe clinic, especially in the Emergency Room. The procedure involves“blindly” landmarking, or landmarking by manually palpating, the lumbarspine, to identify a gap between two spinous processes through which aneedle can be inserted into the epidural or subarachnoid space for fluidcollection or injection. The “blind” landmarking technique improves withtime and practice therefore, physicians with limited experience find thelumbar puncture procedure challenging. Furthermore, regardless ofexperience, the lumbar puncture procedure becomes difficult to performwith obese patients or patients with a high body mass index (BMI)because their high accumulation of subcutaneous adipose tissue preventsthe physician to accurately landmark the lumbar spine via manualpalpation. Current landmarking techniques only have a 30% accuracy,making it necessary for an average of >4 attempts to properly puncturethe space, and resulting in >25% of patients having traumatic lumbarpunctures and >32% of patients left with post-dural puncture headaches(PDPHs). Additionally, elderly patients or pregnant patients havelimited flexibility and are unable to maximally flex the hips, knees,and back, as is required during a lumbar puncture procedure in order toincrease the opening space between the intervertebral disks. Beyond justlandmarking and localization, other functional steps of performing adiagnostic lumbar puncture, where cerebrospinal fluid (CSF) samples arecollected and intracranial pressure is measured, are severelyinefficient. In order to obtain an intracranial pressure reading,physicians use a two-piece manometer connected to a needle hub by athree-way stopcock, which requires estimation of fluid levels indetermining intracranial pressure. To simultaneously balance a manometerand one or more cerebrospinal fluid collection tubes requiressignificant dexterity and/or sometimes more than one pair of hands.Thus, the risk of CSF spillages is high and further increases the riskof contamination. Accordingly, there is a need for improved devices,methods, systems, and kits to perform a lumbar puncture. There is also aneed for improved devices, methods, systems and kits to visualize boneand non-bone structures. In view of these deficiencies in the currentstate of the art, the subject matter presented herein addresses theseand other needs.

Lumbar Punctures

A lumbar puncture is an invasive procedure performed in a clinicalsetting for diagnostic or therapeutic purposes. A diagnostic lumbarpuncture, also known as “spinal tap,” is one of the most commonlyinvasive tests performed in the clinic. Every year, approximately400,000 diagnostic lumbar punctures are performed in the United States.During a lumbar puncture, cerebrospinal fluid is collected and in somecases, cerebrospinal fluid (CSF) opening pressure is measured.Therapeutic lumbar punctures are most commonly performed to deliverspinal anesthesia, intrathecal chemotherapeutics, intrathecal painkillers, intrathecal antibiotics, and contrast agents.

In some instances, a lumbar puncture is performed with a patient in alateral decubitus position or lying down on their side, knees bent, andhead in a neutral position. In some instances, a lumbar puncture isperformed with a patient upright, seated with the chin down and feetsupported. Aseptic technique is used when performing a lumbar puncture.In some instances, to perform a lumbar puncture, a practitioner performsa series of steps including: identifying an intraspineous process spacebetween the 4^(th) and 5^(th) lumbar vertebrae (L4 and L5), between L3and L4, or between L2 and L3; cleaning the patient's skin in the lumbararea with iodinated solution, ethanol or isopropyl alcohol, andchlorhexidine; administering a local anesthetic such as, but not limitedto, xylocaine or lidocaine, in a manner such that it raises a small blebon the skin; administering additional local anesthetic, such aslidocaine, to deeper subcutaneous and intraspinous tissues; slowlyinserting a spinal needle angling towards the patient's head until theepidural or subarachnoid space is entered.

Diagnostic Lumbar Puncture

During a diagnostic lumbar puncture, a needle is inserted between twolumbar vertebrae and into the spinal canal in order to remove asample(s) of cerebrospinal fluid (CSF), which surrounds the brain andthe spinal cord. In some instances, the CSF is collected and itsphysical, chemical, microscopic, and infectious properties areinspected. Physical properties of CSF that are checked include: color,turbidity, and viscosity. Chemical components of CSF that are routinelytested for include glucose and proteins. However, additional testingincludes: protein electrophoresis to distinguish different types ofprotein; immunoglobulin G (IgG) detection; myelin basic proteindetection; lactic acid detection; lactate dehydrogenase detection;glutamine detection; C-reactive protein detection; tumor markers such ascarcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and humanchorionic gonadotropin (hCG); amyloid beta 42 (Aβ42) protein detection;and tau protein detection. Microscopic examination of CSF comprisesanalyzing the sample for total cell counts including red and white bloodcells; additionally, in some instances, a cytology test is performed todetermine the presence or absence of abnormal cells such as tumor cellsor immature blood cells. Infectious tests performed include: CSF gramstain, culture, and sensitivity test to detect microorganisms andpredict best choices for antimicrobial therapy; detection of virusesusing polymerase chain reaction (PCR); detection of CSF cryptococcalantigen to detect a fungal infection caused by yeast; detection ofspecific antibodies; CSF acid-fast bacilli (AFB) test to detectmycobacteria such as Mycobacterium tuberculosis; detection of parasites;and CSF syphilis test.

In some instances, diagnostic lumbar punctures are used to diagnose:bacterial, fungal, and viral infections including meningitis,encephalitis, and neurosyphilis or syphilis; bleeding around the brainor spinal cord including subarachnoid hemorrhages; inflammation of thebrain, spinal cord, or bone marrow including myelitis; cancer includingbrain cancer, spinal cord cancer, and leukemia; neurological disordersincluding demyelinating diseases such as multiple sclerosis anddemyelination polyneuropathy, Guillain-Barré syndrome, mitochondrialdisorders, leukencephalopathies, paraneoplastic syndromes, Reyesyndrome; headaches of unknown cause; and intracranial pressuredisorders including pseudotumor cerebri also known as idiopathicintracranial hypertension (IIH), spontaneous intracranial hypotension,and normal pressure hydrocephalus.

Therapeutic Lumbar Puncture

Therapeutic lumbar punctures are performed in the same manner asdiagnostic lumbar punctures however, instead of collecting a sample ofCSF, a therapeutic agent is delivered to the subarachnoid space. In someembodiments, therapeutic agents delivered via a lumbar puncture includebut are not limited to: anesthetics such as bupivacaine, lidocaine,tetracaine, procaine, ropivacaine, levobupivacaine, prilocaine, andcinchocaine; opioids such as morphine, fentanyl, diamorphine,buprenorphine, and pethidine or meperidine; non-opioids such asclonidine; chemotherapeutic agents such as methotrexate, cytarabine,hydrocortisone, and thiotepa; contrast agents or dyes such as iohexol,metrizamide, iopamidol, ioversol, iopromide, iodixanol, iolotran, andiodophenylundecylic acid; anti-spasmodic agents such as baclofen;antibiotics such as gentamicin sulphate; proteins such as idursulfase.

Tactile Sensing Device Tactile Sensing Device: Device

Disclosed herein, in certain embodiments, are tactile sensing devicesfor imaging bone and non-bone structures in an individual in needthereof, comprising: a display screen 1032, 2032 to visualize an imageof the bone and non-bone structures; and a needle guide 1002, 2002operatively configured to guide a needle into a target tissue locationwithin the individual, as shown in FIGS. 1A, 1B, 1C, 2A, 2B, and 2C. Insome embodiments, the tactile sensing device 1000, 2000 images a firstand second bone and non-bone structure.

Sensor Arrays

In some embodiments, the tactile sensing device 1000 comprises an arrayof sensors 1008. In some embodiments, the sensor array 1008 is a tactilesensor array. In some embodiments, the sensor array 1008 is anultrasound sensor array. In some embodiments, the sensor array 1008 isan infrared radiation (IR) sensor array. In some embodiments, the sensorarray 1008 comprises sensors that are piezoresistive sensors. In someembodiments, the sensor array 1008 comprises sensors are piezoelectricsensors. In some embodiments, the sensor array 1008 comprises sensorsthat are optical sensors. In some embodiments, the sensor array 1008comprises sensors that are electromagnetic sensors. In some embodiments,the sensor array 1008 comprises sensors that are capacitive sensors. Insome embodiments, the sensor array 1008 comprises sensors that arepotentiometric sensors.

In some embodiments, the sensor array 1008 comprises pressure sensors.In some embodiments, the pressure sensors are force-sensitive resistors.Force-sensitive resistors change their resistance in response to achange in force applied to their surface. In some embodiments, theforce-sensitive resistors decrease their resistance with an increase inforce applied the surface of the sensor. In some embodiments, the sensorarray comprises at least one sensor configured to output a signal inresponse to a change in force applied to its surface. Force-sensitiveresistors are two wire devices with a resistance that depends on appliedforce. In some embodiments, the force-sensitive resistors comprise avoltage divider. In some embodiments, the voltage divider outputs avoltage value that is correlated to the resistance; thus, the outputvoltage value also changes in response to a force applied to the surfaceof the sensor. In some embodiments, an increase in voltage indicates anincrease in a force applied to the surface of the sensor. In someinstances, the force-sensitive resistors output voltage signals. In someembodiments, the array of force-sensitive resistors is a 6×3 arraycomprising eighteen force-sensitive resistors. In some embodiments, thearray of force-sensitive resistors is an 8×4 array comprising thirty twoforce-sensitive resistors. In some embodiments, the size of the array offorce-sensitive resistors is dependent upon the surface area of theindividual's body to be examined. In some embodiments, the array offorce-sensitive resistors is configured in a way that is sufficient tovisualize the bone and non-bone structures in the individual.

In some embodiments, as shown in FIGS. 3A and 3B, the sensor array 3008is secured onto a sensor array platform 3022. In some embodiments, thesensor array platform 3022 comprises cylindrical struts 3026 onto whichthe sensors are adhered to. In some embodiments, the cylindrical struts3026 onto which the sensors are adhered are connectors. In someembodiments, the cylindrical struts or connectors are not cylindrical,but rather rectangular or square shaped. In some embodiments, thecylindrical struts are spring loaded connectors. In some embodiments,the cylindrical struts 3026 are Pogo pins. In some embodiments, the Pogopins establish a connection to a printed circuit board (PCT) or betweenpluralities of PCTs. Non-limiting types of Pogo pins include verticalmount surface mount technology (SMT), vertical type, through hole type,horizontal type, right angle type, cable solder type, or water proofconnector type. In some embodiments, the sensor 3016 is covered with ahemispherical disk 3024 configured to enhance force feedback. In someembodiments, the hemispherical disk 3024 covering the force-sensitiveresistors is a hemispherical rubber disk. In some embodiments, therubber material includes, but is not limited to: silicone rubber,natural rubber, acrylonitrile-butadiene rubber, hydrogenatedacrylonitrile-butadiene rubber, ethylene propylene diene rubber,fluorocarbon rubber, chloroprene rubber, fluorosilicone rubber,polyacrylate rubber, ethylene acrylic rubber, styrene-butadiene rubber,polyester urethane rubber, or polyether urethane rubber.

Bone and Non-Bone Structures

In some embodiments, the tactile sensing device images a target tissuelocation. In some embodiments, the desired target tissue location is thebone marrow. In some embodiments, the tactile sensing device images boneand non-bone structures around a target tissue location. In someembodiments, the tactile sensing device images the lumbar vertebrae andthe non-bone structures surrounding the lumbar vertebrae. In someembodiments, the tactile sensing device images the sacral vertebrae andthe non-bone structures surrounding the sacral vertebrae. In someembodiments, the tactile sensing device images the lumbar and sacralvertebrae and the non-bone structures surrounding the lumbar and sacralvertebrae. In some embodiments, the tactile sensing device images thespinous processes and the non-bone structures surrounding the spinousprocesses. In some embodiments, the tactile sensing device images the L3and L4 spinous processes and the non-bone structures surrounding the L3and L4 spinous processes. In some embodiments, the tactile sensingdevice images the L5 and L5 spinous processes and the non-bonestructures surrounding the L4 and L5 spinous processes. In someembodiments, the tactile sensing device images the L5 and S1 spinousprocesses and the non-bone structures surrounding the L3 and L4 spinousprocesses.

In some embodiments, the tactile sensing device 1000, 2000 images afirst and second bone and non-bone structures. In some embodiments, thetactile sensing device 1000, 2000 images a plurality of bone andnon-bone structures. In some embodiments, a bone structure is a rib. Insome embodiments, a bone structure is an articular surface. In someembodiments an articular surface is a vertebral articulation, anarticulation of a first bone of a hand with a second bone of the hand,an elbow joint, a wrist joint, an axillary articulation of a first boneof a shoulder with a second bone of the shoulder, a sternoclavicularjoint, a temporomandibular joint, a sacroiliac joint, a hip joint, aknee joint, or an articulations of a first bone of a foot with a secondbone of the foot. In some instances, a vertebral articulation is aspinous process. In some embodiments, a non-bone structure issubcutaneous tissue, a muscle, a ligament, adipose tissue, a cyst, or acavity.

Display Screen

As shown in FIGS. 1A, 1B, 1C, 2A, 2B, and 2C, in some embodiments, thetactile sensing device 1000, 2000 comprises a display screen 1032, 2032to provide visual information to a user. In some embodiments, thedisplay screen 1032, 2032 is operatively connected to the tactilesensing device 1000, 2000. In some embodiments, the display screen 1032,2032 is a computer screen, a mobile device screen, or a portable devicescreen. In some embodiments, the display screen 1032, 2032 is a cathoderay tube (CRT). In some embodiments, the display screen 1032, 2032 is aliquid crystal display (LCD). In further embodiments, the display screen1032, 2032 is a thin film transistor liquid crystal display (TFT-LCD).In some embodiments, the display screen 1032, 2032 is an organic lightemitting diode (OLED) display. In various further embodiments, an OLEDdisplay is a passive-matrix OLED (PMOLED) or active-matrix OLED (AMOLED)display. In some embodiments, the display screen 1032, 2032 is a plasmadisplay. In other embodiments, the display screen 1032, 2032 is a videoprojector. In still further embodiments, the display screen 1032, 2032is a combination of devices such as those disclosed herein.

In some embodiments, the visual information provided to the user via adisplay screen 1032 is a pressure map representing bone and non-bonestructures. In some embodiments, the pressure map is a heat map. In someembodiments, the sensor array comprises at least one sensor configuredto output a signal in response to a change in force applied to itssurface, wherein the signal is represented as a heat map. In someembodiments, the heat map is a graphical representation of voltagesignals wherein the individual voltage output signals are represented asa plurality of colors, color hues, color saturations, graphicalpatterns, shading, geometrical figures, or any combination thereof. Insome embodiments, high voltage output signals are represented in ared-based color and low voltage output signals are represented inblue-based color. In some embodiments, the pressure map is overlaid ontoa second image. In some embodiments, the second image is a type ofdiagnostic image including, but not limited to: radiography image,magnetic resonance imaging (MRI) image, computed tomography (CT) image,nuclear medicine image, ultrasound image, photoacoustic image, orthermography image. In some embodiments, the second image is an image ofbone and non-bone structures. In some embodiments, the second image of abone and non-bone structure is an image of a rib; an articular surfacesuch as, a vertebral articulation, an articulation of a first bone of ahand with a second bone of the hand, an elbow joint, a wrist joint, anaxillary articulation of a first bone of a shoulder with a second boneof the shoulder, a sternoclavicular joint, a temporomandibular joint, asacroiliac joint, a hip joint, a knee joint, or an articulations of afirst bone of a foot with a second bone of the foot; non-bone structureis subcutaneous tissue, a muscle, a ligament, adipose tissue, a cyst, ora cavity.

Needle Guide

In some embodiments, as shown in FIGS. 1A, 1B, and 1C, a needle guide1002 is operatively connected to the tactile sensing device 1000. Insome embodiments, the needle guide 1002, operatively connected to thetactile sensing device 1000, is used to control the angle and directionof a needle that is inserted into an individual in need thereof. In someembodiments, the needle guide 1002 is oriented between a −45° and 45°cephalad angle, terminating at a needle orifice 1038 located on thecenter of the sensor array 1008, thereby controlling the angle at whichthe needle is inserted into a human body. In some embodiments, theneedle guide 1002 is oriented between a −45° and 45° cephalad angle,wherein −45° is equivalent to 315°. In some embodiments, the needleguide allows for the needle to be inserted into an individual at acephalad angle between about 10° and about 20°.

In some embodiments, the needle guide allows for the needle to beinserted into an individual at a cephalad angle between about 0° andabout 30°. In some embodiments, the needle guide allows for the needleto be inserted into an individual at a cephalad angle between about 0°and about 50°.

In some embodiments, the needle guide 1002 is oriented between a 0° and15° cephalad angle. In some embodiments, the needle guide 1002 isoriented between a 15° and 30° cephalad angle. In some embodiments, theneedle guide 1002 is oriented between a 30° and 45° cephalad angle. Insome embodiments, the needle guide 1002 is oriented between a 45° and60° cephalad angle. In some embodiments, the needle guide 1002 isoriented between a 0° and −15° cephalad angle. In some embodiments, theneedle guide 1002 is oriented between a −15° and −30° cephalad angle. Insome embodiments, the needle guide 1002 is oriented between a −30° and−45° cephalad angle. In some embodiments, the needle guide 1002 isoriented between a −45° and −60° cephalad angle. In some embodiments,the needle guide 1002 is oriented at a 0° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 1° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 2° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 3°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 4° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 5° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 6° cephalad angle. In some embodiments, the needleguide 1002 is oriented at a 7° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at an 8° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 9° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 10° cephaladangle. In some embodiments, the needle guide 1002 is oriented at an 11°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 12° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 13° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 14° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 15° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 16° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 17° cephaladangle. In some embodiments, the needle guide 1002 is oriented at an 18°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 19° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 20° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 21° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 22° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 23° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 24° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 25°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 26° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 27° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 28° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 29° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 30° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 31° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 32°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 33° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 34° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 35° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 36° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 37° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 38° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 39°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 40° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 41° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 42° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 43° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 44° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 45° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 46°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 47° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 48° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 49° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 50° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 51° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 52° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 53°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 54° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 55° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 56° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 57° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 58° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 59° cephaladangle. In some embodiments, the needle guide 1002 is oriented at a 60°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 315° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 316° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 317° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 318° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 319° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 320°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 321° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 322° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 323° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 324° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 325° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 326°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 327° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 328° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 329° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 330° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 331° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 332°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 333° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 334° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 335° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 336° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 337° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 338°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 339° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 340° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 341° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 342° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 343° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 344°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 345° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 346° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 347° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 348° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 349° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 350°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 351° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 352° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 353° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 354° cephalad angle. In someembodiments, the needle guide 1002 is oriented at a 355° cephalad angle.In some embodiments, the needle guide 1002 is oriented at a 356°cephalad angle. In some embodiments, the needle guide 1002 is orientedat a 357° cephalad angle. In some embodiments, the needle guide 1002 isoriented at a 358° cephalad angle. In some embodiments, the needle guide1002 is oriented at a 359° cephalad angle. In some embodiments, theneedle guide 1002 is oriented at a 360° cephalad angle. In someembodiments, the needle orifice 1038 located on the center of the sensorarray 1008 is an elongated slit. In some embodiments, the needle guide1002 terminates at a plurality of openings formed by an elongated slitwith a plurality of columns.

In various further embodiments, as shown in FIGS. 2A, 2B, and 2C, aneedle guide cartridge 2012 is operatively connected to the tactilesensing device 2000. In some embodiments, the needle guide cartridge2012 is oriented between a −45° and 45° cephalad angle, terminating at aneedle orifice 2038 located along the midline of the sensor array 2008,thereby controlling the angle at which the needle is inserted into ahuman body. In some embodiments, the needle guide cartridge 2012 isoriented between a −45° and 45° cephalad angle, wherein −45° isequivalent to 315°. In some embodiments, the needle guide cartridge 2012is oriented between a 0° and 15° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented between a 15° and 30°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented between a 30° and 45° cephalad angle. In some embodiments, theneedle guide cartridge 2012 is oriented between a 45° and 60° cephaladangle. In some embodiments, the needle guide cartridge 2012 is orientedbetween a 0° and −15° cephalad angle. In some embodiments, the needleguide cartridge 2012 is oriented between a −15° and −30° cephalad angle.In some embodiments, the needle guide cartridge 2012 is oriented betweena −30° and −45° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented between a −45° and −60° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 0°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 1° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 2° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 3° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 4°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 5° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 6° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 7° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at an 8°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 9° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 10° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at an 11° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 12°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 13° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 14° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 15° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 16°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 17° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at an 18° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 19°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 20° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 21° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 22° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 23°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 24° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 25° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 26° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 27°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 28° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 29° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 30° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 31°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 32° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 33° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 34° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 35°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 36° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 37° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 38° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 39°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 40° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 41° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 42° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 43°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 44° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 45° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 46° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 47°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 48° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 49° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 50° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 51°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 52° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 53° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 54° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 55°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 56° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 57° cephalad angle. In some embodiments,the needle guide cartridge 2012 is oriented at a 58° cephalad angle. Insome embodiments, the needle guide cartridge 2012 is oriented at a 59°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 60° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 315° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 316°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 317° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 318° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 319°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 320° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 321° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 322°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 323° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 324° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 325°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 326° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 327° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 328°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 329° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 330° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 331°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 332° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 333° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 334°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 335° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 336° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 337°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 338° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 339° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 340°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 341° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 342° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 343°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 344° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 345° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 346°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 347° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 348° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 349°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 350° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 351° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 352°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 353° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 354° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 355°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 356° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 357° cephalad angle. In someembodiments, the needle guide cartridge 2012 is oriented at a 358°cephalad angle. In some embodiments, the needle guide cartridge 2012 isoriented at a 359° cephalad angle. In some embodiments, the needle guidecartridge 2012 is oriented at a 360° cephalad angle. In someembodiments, the needle guide cartridge 2012 terminates at an opening.In some embodiments, the needle guide cartridge 2012 terminates at anopening. In some embodiments, the needle orifice 2038 located on thecenter of the sensor array 2008 is an elongated slit.

Multiplexer

In some embodiments, the tactile sensing device 1000, 2000 furthercomprises a multiplexer. The multiplexer selects voltage output signalsfrom the sensor 3016 and forwards the selected voltage output signalsinto a single line. In some embodiments, the multiplexer is an analogmultiplexer. In some embodiments, the analog multiplexer is a 16:1 or an8:1 multiplexer. In some embodiments, the analog multiplexer is afrequency division multiplexer or a wave division multiplexer. Invarious further embodiments, the multiplexer is a digital multiplexer.In some instances, the digital multiplexer is a time divisionmultiplexer. In some embodiments, the time division multiplexer is asynchronous time division multiplexer or an asynchronous time divisionmultiplexer. In some embodiments, the multiplexer is mounted onto aprinted circuit board.

Voltage Divider

In some embodiments, the tactile sensing device further comprises avoltage divider. In some embodiments, the voltage divider is a componentof a force-sensitive resistor. In some embodiments, the force-sensitiveresistor is coupled to a measuring resistor R_(M) in a voltage divider.In some embodiments, the output voltage signal from the force-sensitiveresistors is read out using a voltage divider. In some embodiments, theoutput voltage signal read out using the voltage divider is described byEquation 1 below.

Equation 1: V_(OUT)=(R_(M) V_(IN))/(R_(M)+R_(FSR)); wherein V_(OUT) isthe output voltage signal, R_(M) is the measuring resistor, V_(IN) isthe input voltage signal, and R_(FSR) is the resistance detected by theforce-sensitive resistor.

In some embodiments, the voltage divider is a resistive voltage divider,a low-pass RC filter voltage divider, an inductive voltage divider, or acapacitive voltage divider.

Computing Device

In some embodiments, the tactile sensing device 1000, 2000 furthercomprises a computing device. In some embodiments, the computing deviceis a microcontroller. In some embodiments, the microcontroller is an8-bit, 16-bit, or 32-bit microcontroller. In some embodiments, themicrocontroller is an 8051 microcontroller, a programmable interfacecontroller (PIC), an AVR or Advanced Virtual RISC microcontroller, or anARM® microcontroller. In some embodiments, the microcontroller is, byway of non-limiting examples, an Arduino Uno microcontroller or aRaspberry Pi microcontroller.

In some embodiments, the computing device is a desktop computer or alaptop computer. In some embodiments, the computing device is a mobiledevice. In some embodiments, the mobile device is a smart phone or asmart watch. In some embodiments, the computing device is a portabledevice. In accordance with the description herein, suitable computingdevices further include, by way of non-limiting examples, notebookcomputers, tablet computers, netbook computers, smart book computers,subnotebook computers, ultra-mobile PCs, handheld computers, personaldigital assistants, Internet appliances, smart phones, music players,and portable video game systems. Many mobile smart phones are suitablefor use in the systems described herein. Suitable tablet computersinclude those with booklet, slate, and convertible configurations.Suitable portable video game systems include, by way of non-limitingexamples, Nintendo DS™ and Sony PSP™ Voltage Source

In some embodiments, the tactile sensing device 1000, 2000 furthercomprises a voltage source. In some embodiments, the voltage source is abattery. In some embodiments, the voltage source is rechargeable. Insome embodiments, the voltage source is removable. In some embodiments,the voltage source includes, but is not limited to: a nickel cadmium(NiCd) battery, nickel-metal hydride (NiMH) battery, a nickel zinc(NiZn) battery, a lead acid battery, a lithium ion battery (Li-ion), ora lithium ion polymer (Li-ion polymer) battery.

Pressure Sensor

A critical component of a lumbar puncture is the recording ofintracranial (ICP) pressure, represented by the ultra-low pressure ofthe cerebrospinal fluid. ICP or cerebrospinal fluid pressure istypically in the 8-15 mmHg (10-20 mbar) range. Cerebrospinal fluidpressure is typically determined using a two-piece manometer attached toa 3-way stopcock valve which is connected to a spinal needle.

In some embodiments, the tactile sensing device 1000, 2000 furthercomprises a pressure sensor operatively connected to the tactile sensingdevice 1000, 2000 and configured to measure cerebrospinal fluidpressure. In some embodiments, the pressure sensor is operativelyconnected to the tactile sensing device 2000 via a 3-way valve 2014. Insome embodiments, the pressure sensor is an electronic pressure sensor.In some instances, the pressure sensor is a piezoresistive, capacitive,electromagnetic, piezoelectric, optical, or potentiometric pressuresensor. In some embodiments, cerebrospinal fluid pressure measured withthe electronic pressure sensor is displayed digitally. In someembodiments, cerebrospinal fluid pressure measured with the electronicpressure sensor is displayed on a display screen 1032 in real-time.

In some embodiments, the electronic pressure sensor is a HoneywellTruStability®, board mount pressure sensor, which is capable of sensing0-60 mbar. In some embodiments, the electronic pressure sensor is anuncompensated and unamplified piezoresistive silicon pressure sensor. Insome embodiments, the electronic pressure sensor is operativelyconnected to a barbed port. In some embodiments, the barbed port isliquid-compatible and replaces a traditional manometer connected to a3-way stopcock valve.

Fluid Collection Systems

In some embodiments, the tactile sensing device further comprises afluid collection system configured to collect a fluid such ascerebrospinal fluid. In some embodiments, the fluid collection system isdisposable. In some embodiments, the fluid collection system is adiaphragm fluid collection system 5042. In some embodiments, the fluidcollection system is a faucet fluid collection system 1006. In someembodiments, the fluid collection system is a top faucet fluidcollection system 6120. In some embodiments, the fluid collection systemis a spoke fluid collection system 7058. In some embodiments, the fluidcollection system is a rail fluid collection system 8062.

In some embodiments, tactile sensing device 1000, 2000 comprises adiaphragm fluid collection system 5042, as shown in FIG. 5. In someembodiments, the diaphragm fluid collection system 5042 comprises a setof stackable collection tubes 5010. The first collection tube 5010 a,the second collection tube 5010 b, the third collection tube 5010 c, andthe fourth collection tube 5010 d comprises a first diaphragm 5044 a, asecond diaphragm 5044 b, and a third diaphragm 5044 c. To collect afluid with the diaphragm fluid collection system 5042, a cap 5046 isfirst threaded off the first collection tube 5010 a. The stackablecollection tubes 5010 are placed under a needle hub, a 3-way valve, ortubing connected to a 3-way valve, with the first diaphragm 5044 a, thesecond diaphragm 5044 b, and the third diaphragm 5044 c in the openposition. Once sufficient fluid is collected in the fourth collectiontube 5010 d, the third diaphragm 5044 c is closed and the thirdcollection tube 5010 c, the second collection tube 5010 b, and the firstcollection tube 5010 a are subsequently filled in the same manner.

In some embodiments, the fluid collection system operatively connectedto the tactile sensing tactile sensing device comprises a top faucetfluid collection system 6120, as shown in FIG. 6. In some embodiments,the top faucet fluid collection system 6120 further comprises acontainer 6056 into which open collection tubes 6010 are placed.Additionally, the top faucet fluid collection system 6120 furthercomprises a rotating handle 6052 attached to a faucet base 6054 to whichthe collection tubes 6010 (1010, as shown in FIG. 1) are connected to.Above the collection tubes 6010, is a plate with a single hole (notshown in FIG. 6) located beneath a faucet connector 6050, which connectsdirectly to a needle hub or a 3-way valve 2014. Once a first collectiontube 6010 a is sufficiently filled with fluid, the rotating handle 6052is rotated clockwise or counterclockwise to allow for filling of thesecond collection tube 6010 b, and the process repeats until allcollection tubes 6010 are filled with fluid.

In some embodiments, the tactile sensing device comprises a spoke fluidcollection system 7058, as shown in FIG. 7. In some embodiments, thespoke fluid collection system 7058 comprises a central hub 7060 withfour central hub openings 7086. In some embodiments, the collectiontubes 7010 are operatively connected to the central hub 7060. In someembodiments, the collection tubes 7010 are threaded into the central hubopenings 7086. In some embodiments, the collection tubes 7010 aresnapped into the central hub openings 7086. In some embodiments, thecollection tubes 7010 are operatively connected to the central hubopenings 7086 via a snap fitting. The spoke fluid collection system 7058further comprises a spoke connector 7088 connecting the central hub 7060to a needle hub or a three-way valve. Fluid flows from a needle hub or athree-way valve through the spoke connector 7088 and into a firstcollection tube 7010 a. In some embodiments, the fluid exits the spokeconnector 7088 and flows only into a first collection tube 7010 a thatis immediately underneath the spoke connector 7088. The spoke fluidcollection system 7058 further comprises a knob (not shown in FIG. 7)secured to the back face of the central hub 7060, which is rotatedclockwise or counterclockwise to allow for sequential filling of thecollection tubes 7010. In some embodiments, the knob either clicks intoplace or has markings corresponding to four positions, which, whenaligned, signals whether a first collection tube 7010 a, a secondcollection tube 7010 b, a third collection tube 7010 c, or a fourthcollection tube 7010 d is in position to be filled. Once a firstcollection tube 7010 a is sufficiently filled, the knob is turnedclockwise or counterclockwise to allow a second collection tube 7010 b,a third collection tube 7010 c, or a fourth collection tube 7010 d to befilled. In some embodiments, the central hub openings 7086 comprisegaskets. In some embodiments, the gaskets prevent fluid from spilling orexiting the collection tubes 7010 during or between filling periods.

In some embodiments, the tactile sensing device comprises a rail fluidcollection system 8062, as shown in FIGS. 2 and 8. In some embodiments,the rail fluid collection system 8062 comprises a rail platform 8064located beneath a needle hub connector 8100, a fluid connector 8068, ora three-way valve 8014. The rail platform 8064 slides along guide rails8134, which are operatively connected to the tactile sensing device. Insome embodiments, the fluid collection tubes 8010 are placed beneath afluid connector 8068 to allow for fluid collection. Once fluid begins toflow, the user waits for a first collection tube 8010 a to fill; then,the user slides the rail platform 8064 containing the collection tubes8010 to allow for sequential filling of a second collection tube 8010 b,a third collection tube 8010 c, and a fourth collection tube 8010 d.

Frame

In some embodiments, as shown in FIGS. 1A, 1B, 1C, 2A, 2B, and 2C, thetactile sensing device 1000, 2000 comprises a frame 1018. In someembodiments, the frame 1018 is a basic structure that supports themodular components of the tactile sensing device. In some embodiments,the frame 1018 or 2018 holds the modular components of the tactilesensing device. In some embodiments, the frame 1018 or 2018 has aplurality of voids that are filled with a plurality of protrusions fromthe modular components of the tactile sensing device. In someembodiments, the modular components of the tactile sensing deviceinclude a sensor array 1008, 2008, 3008, the diaphragm fluid collectionsystem 5042, the faucet fluid collection system 6048, the spoke fluidcollection system 7058, or the rail fluid collection system 8062. Insome embodiments, the frame 1018 or 2018 is composed of a metal,plastic, or elastomer material. In some embodiments, the frame 1018 or2018 is made out of a plastic or elastomer material including, but notlimited to: polyethylene; polypropylene; polystyrene; polyester;polylactic acid (PLA); polycarbonate, polyvinyl chloride,polyethersulfone, polyacrylate or acrylic or polymethylmethacrylate(PMMA); polysulfone; polyetheretherketone; thermoplastic elastomers orthermoplastic urethanes; or poly-p-xylylene or parylene.

Handle

In some embodiments, as shown in in FIGS. 1A, 1B, and 1C, the tactilesensing device comprises a handle 1004. In some embodiments, the handle1004 is operatively connected to the tactile sensing device 1000. Insome embodiments, the handle 1004 is a part of the tactile sensingdevice 1000 by which the tactile sensing device 1000 is held,controlled, carried, maneuvered, or gripped. In some embodiments, thegripper 1004 orients the user's hand in a forward orientation. In someembodiments, as shown in in FIGS. 2A, 2B, and 2C, the tactile sensingdevice comprises a gripper 2020. In some embodiments, the gripper 2020is operatively connected to the tactile sensing device 2000. In someembodiments, the gripper 2020 is a part of the tactile sensing device2000 by which the tactile sensing device 2000 is held, controlled,carried, maneuvered, or gripped. In some embodiments, as shown in FIGS.2A, 2B, and 2C, the gripper 2020 is ergonomically shaped and configuredto enhance application of force to the tactile sensing device 2004. Insome embodiments, a fluid collection system is contained within a voidinside the handle of the tactile sensing device 1000. In someembodiments, the handle 1004 or gripper 2020 comprises a plastic orelastomer material including, but not limited to: polyethylene;polypropylene; polystyrene; polyester; polylactic acid (PLA);polycarbonate, polyvinyl chloride, polyethersulfone, polyacrylate oracrylic or polymethylmethacrylate (PMMA); polysulfone;polyetheretherketone (PEEK); thermoplastic elastomers or thermoplasticurethanes; or polyp-xylylene or parylene. In some embodiments, thehandle 1004 or gripper 2020 is made out of a rubber material including,but not limited to: silicone rubber, natural rubber,acrylonitrile-butadiene rubber, hydrogenated acrylonitrile-butadienerubber, ethylene propylene diene rubber, fluorocarbon rubber,chloroprene rubber, fluorosilicone rubber, polyacrylate rubber, ethyleneacrylic rubber, styrene-butadiene rubber, polyester urethane rubber, orpolyether urethane rubber.

Tactile Sensing Device: Systems

Disclosed herein, in certain embodiments, are systems for imaging boneand non-bone structures in an individual in need thereof, comprising: atactile sensing device to detect voltage signals resulting fromapplication of force to the tactile sensing device against theindividual; a display screen to visualize an image of the bone andnon-bone structures obtained from the voltage signals detected by thetactile sensing device; and a computing device comprising: at least oneprocessor operatively coupled to the tactile sensing device; a memorydevice; and a non-transitory computer readable storage medium with acomputer program including instructions executable by the processorcausing the processor to convert the voltage signals into the image.

Bone and Non-Bone Structures

In some embodiments, the systems for imaging bone and non-bonestructures image a first and second bone and non-bone structures. Insome embodiments, the systems for imaging bone and non-bone structuresimage a plurality of bone and non-bone structures. In some embodiments,a bone structure is a rib. In some embodiments, a bone structure is anarticular surface. In some embodiments an articular surface is avertebral articulation, an articulation of a first bone of a hand with asecond bone of the hand, an elbow joint, a wrist joint, an axillaryarticulation of a first bone of a shoulder with a second bone of theshoulder, a sternoclavicular joint, a temporomandibular joint, asacroiliac joint, a hip joint, a knee joint, or an articulations of afirst bone of a foot with a second bone of the foot. In some instances,a vertebral articulation is a spinous process. In some embodiments, anon-bone structure is subcutaneous tissue, a muscle, a ligament, adiposetissue, a cyst, or a cavity.

Sensor Array

In some embodiments, the tactile sensing device 1000 comprises a sensorarray 1008. In some embodiments, the sensor array comprises a pluralityof sensors. In some embodiments, the sensors are tactile sensors. Insome embodiments, the sensors are force-sensitive resistors. In someembodiments, the force-sensitive resistors change their resistive valuein response to a change in applied pressure. In some instances, theforce-sensitive resistors output voltage signals. In some embodiments,the array of force-sensitive resistors is a 6×3 array comprisingeighteen force-sensitive resistors. In some embodiments, the array offorce-sensitive resistors is an 8×4 array comprising thirty twoforce-sensitive resistors. In some embodiments, the size of the array offorce-sensitive resistors is dependent upon the surface area of theindividual's body to be examined. In some embodiments, the array offorce-sensitive resistors is configured in a way that is sufficient tovisualize the bone and non-bone structures in the individual.

In some embodiments, as shown in FIGS. 3A and 3B, the array offorce-sensitive resistors is secured onto a sensor array platform 3022.In some embodiments, the sensor array platform 3022 comprisescylindrical struts 3026 onto which the sensors are adhered to. In someembodiments, the cylindrical struts 3026 onto which the sensors areadhered to are struts or connectors of any shape that adequatelysupports the sensors being used.

Display Screen

As shown in FIGS. 1A, 1B, 1C, 2A, 2B, and 2C, in some embodiments, thetactile sensing device 1000, 2000 comprises a display screen 1032, 2032to provide visual information to a user. In some embodiments, thedisplay screen 1032 is operatively connected to the tactile sensingdevice 1000. In some embodiments, the display screen 2032 is operativelyconnected to the tactile sensing device 2000. In some embodiments, thedisplay screen is a computer screen, a mobile device screen, or aportable device screen. In some embodiments, the display screen is acathode ray tube (CRT). In some embodiments, the display screen is aliquid crystal display (LCD). In further embodiments, the display screenis a thin film transistor liquid crystal display (TFT-LCD). In someembodiments, the display screen is an organic light emitting diode(OLED) display. In various further embodiments, an OLED display is apassive-matrix OLED (PMOLED) or active-matrix OLED (AMOLED) display. Insome embodiments, the display screen is a plasma display. In otherembodiments, the display screen is a video projector. In still furtherembodiments, the display screen is a combination of devices such asthose disclosed herein.

In some embodiments, the visual information provided to the user via adisplay screen is a pressure map representing bone and non-bonestructures. In some embodiments, the pressure map is a heat map. In someembodiments, the heat map is a graphical representation of voltagesignals wherein the individual voltage output signals are represented asa plurality of colors, color hues, color saturations, graphicalpatterns, shading, geometrical figures, or any combination thereof.

Computing Device

In some embodiments, the tactile sensing device further comprises acomputing device. In some embodiments, the computing device is amicrocontroller. In some embodiments, the microcontroller is an 8-bit,16-bit, or 32-bit microcontroller. In some embodiments, themicrocontroller is an 8051 microcontroller, a programmable interfacecontroller (PIC), an AVR or Advanced Virtual RISC microcontroller, or anARM® microcontroller. In some embodiments, the microcontroller is, byway of non-limiting examples, an Arduino Uno microcontroller or aRaspberry Pi microcontroller.

In some embodiments, the computing device is a microprocessor. In someembodiments, the microprocessor is manufactured by AMD®, Intel®, orARM®. In some embodiments, the AMD® microprocessors include, but are notlimited to: AMD Sempron™, AMD Turion II™, AMD Athlon II™, AMD Sempron™,AMD Phenom II™, AMD A-Series, or AMD FX™. In some embodiments, theIntel® microprocessors include, but are not limited to: Intel Atom™,Intel Celeron™, Intel Pentium™, Intel Core i3™, Intel Core i5™, or IntelCore i7™. In some embodiments, the ARM® microprocessors include, but arenot limited to: ARM OMAP 3, ARM MAP 4, ARM OMAP 5, ARM SnapDragon S2,ARM SnapDragon S, ARM SnapDragon S4, ARM Tegra, ARM Tegra 2, ARM Tegra3, ARM Exynos 3 Single, ARM Exynos 4 Dual, ARM Exynos 4 Quad, ARM Exynos5 Dual, ARM A4, ARM A5, or ARM A5X.

In some embodiments, the computing device further comprises a memorydevice. In some embodiments, the processing device includes a memorydevice. A memory device is one or more physical apparatus used to storedata or programs on a temporary basis, a permanent basis, orcombinations thereof. In some embodiments, a memory device is volatileand requires power to maintain stored information. In some embodiments,a memory device is non-volatile and retains stored information and doesnot require power to maintain stored information.

In some embodiments, the computing device further comprises anon-transitory computer readable storage medium with a computer programincluding instructions executable by the processor causing the processorto convert the voltage signals into an image. In some embodiments, thecomputer program includes instructions executable by the processor thatcause the processor to encode the voltage signals into a first andsecond computer signals.

In some embodiments, the computer program includes instructionsexecutable by the processor that cause the processor to calculate aprojected needle position and display it on the display screen. In someembodiments, the computer program includes instructions executable bythe processor that cause the processor to calculate a projected needleposition for any potential needle guide when using a tactile sensingdevice 2000 comprising a needle guide cartridge 2012, as shown in FIGS.2A, 2B, and 2C. In some embodiments, a needle projection calculation isa trigonometric algorithm. In some embodiments, the trigonometricalgorithm determines the depth of the needle once it traversessubcutaneous adipose tissue. In some embodiments, the needle projectioncalculation is adjusted based on amount of subcutaneous adipose tissue.

In some embodiments, the computer program includes instructionsexecutable by the processor causing the processor to: determine, as afirst requirement, a location of a bone detected by the tactile sensingdevice; ii) determine, as a second requirement, the space between saidbone structures; and iii) perform predictive analysis based onapplication of machine learning. In some embodiments, the predictiveanalysis performed by the processor enhances the accuracy of a needleprojection calculation. In some embodiments, the predictive analysisperformed by the processor locates a desired bone and non-bonestructure. In some embodiments, the predictive analysis performed by theprocessor locates a gap between bone and non-bone structures. In someembodiments, the predictive analysis performed by the processor suggestsa needle insertion location to the user based on the voltage signalsdetected by the tactile sensing device.

The computer program is, for example, software, including computeralgorithms, computer codes, programs, and data, which manages thedevice's hardware and provides services for execution of instructions.Suitable computer program languages include, by way of non-limitingexamples, C, C++, C#, Objective C, Perl, Scala, Haskell, Go, Arduino C,Python, Java, SQL, JavaScript, PHP, iOS Swift, or Ruby.

In some embodiments, the computing device is a desktop computer or alaptop computer. In some embodiments, the computing device is a mobiledevice. In some embodiments, the mobile device is a smart phone or asmart watch. In some embodiments, the computing device is a portabledevice. In accordance with the description herein, suitable computingdevices further include, by way of non-limiting examples, notebookcomputers, tablet computers, netbook computers, smart book computers,subnotebook computers, ultra-mobile PCs, handheld computers, personaldigital assistants, Internet appliances, smart phones, music players,and portable video game systems. Many mobile smart phones are suitablefor use in the systems described herein. Suitable tablet computersinclude those with booklet, slate, and convertible configurations.Suitable portable video game systems include, by way of non-limitingexamples, Nintendo DS™ and Sony® PSP™

Signal Transmitter and Receiver

In some embodiments, the processor encodes the voltage signals into afirst and second computer signals. In some embodiments, the tactilesensing device comprises a signal transmitter. In some embodiments, thetactile sensing device comprises a signal receiver. In some embodiments,a transmitter is configured to transmit the first computer signal to acomputing device. In some embodiments, a receiver is configured toreceive the second computer signal from a tactile sensing device. Insome embodiments, the first and second computer signals are transmittedvia a USB (Universal Serial Bus) cable. In some embodiments, the firstand second computer signals are wireless signals.

In some embodiments, the signal receiver is a wireless element. In someembodiments, the signal transmitter is a wireless element. In someembodiments, the wireless element is configured to receive a signal froma computing device, for example, a mobile device. In some embodiments,the signal receiver is a wireless element which is configured to receivea signal from the tactile sensing device. In some embodiments, thewireless element is a wireless network technology. In some embodiments,the wireless network technology is ANT, ANT+, INSTEON, IrDA, WirelessUSB, Bluetooth, Z-Wave, or ZigBee, IEEE 802.15.4, 6LoWPAN, or Wi-Fi.

Needles and Needle Guide

In some embodiments, the system further comprises a needle, a needleguide, a stylet, or a catheter. In some embodiments, the needle is anatraumatic, also known as pencil-point type needle, or a traumaticneedle, also known as a classic needle or a Quincke type needle. In someembodiments, the system further comprises a spinal needle. In someembodiments, the spinal needle is a Quincke spinal needle, a Whitacrespinal needle, or a Sprotte spinal needle. In some embodiments, thesystem further comprises an epidural needle. In some embodiments, theepidural needle is a Weiss epidural needle, a Tuohy epidural needle, ora Hustead epidural needle. In some embodiments, the needle incudes, byway of non-limiting examples, a 6-gauge needle, an 8-gauge needle, a13-gauge needle, a 15-gauge needle, a 17-gauge needle, an 18-gaugeneedle, a 19-gauge needle, a 20-gauge needle, a 21-gauge needle, a22-gauge needle, a 23-gauge needle, a 24-gauge needle, a 25-gaugeneedle, a 26-gauge needle, a 27-gauge needle, a 28-gauge needle, a29-gauge needle, a 30-gauge needle, a 31-gauge needle, and a 32-gaugeneedle. In some embodiments, the needle is a spinal needle rangingbetween 1-10 inches in length. In some embodiments, the needle containsa stylet, also known as an obturator or an introducer, which is a finewire, a slender probe, or a solid rod with a metal hub fitted to match aneedle's bevel. In diagnostic lumbar punctures, a stylet is withdrawnfrom the needle to allow cerebrospinal fluid to flow out from the spinalcanal and through the needle hub.

In some embodiments, the system further comprises a catheter. In someembodiments, the catheter is an epidural tunneled catheter, which isimplanted into the epidural space as a medication delivery port. In someembodiments, the catheter is used to monitor intracranial pressureduring a diagnostic lumbar puncture procedure. In some embodiments, thecatheter is used as means to continuously remove cerebrospinal fluid andrelieve pressure on the brain of a patient suffering from hydrocephalus.

In some embodiments, a needle guide 1002 is operatively connected to thetactile sensing device 1000. In some embodiments, the needle guide 1002,operatively connected to the tactile sensing device 1000, is used tocontrol the angle and direction of a needle that is inserted into anindividual in need thereof. In some embodiments, the needle guide 1002is oriented between a −45° and 45° cephalad angle, terminating at aneedle orifice 1038 located on the center of the sensor array 1008,thereby controlling the angle at which the needle is inserted into ahuman body. In some embodiments, the needle guide 1002 is oriented at a15° cephalad angle. In some embodiments, the needle orifice 1038 locatedon the center of the sensor array 1008 is an elongated slit. In someembodiments, the needle guide 1002 terminates at a plurality of openingsformed by an elongated slit with a plurality of columns. In variousfurther embodiments, as shown in FIGS. 2A, 2B, and 2C, a needle guidecartridge 2012 is operatively connected to the tactile sensing device2000. In some embodiments, the needle guide cartridge 2012 is orientedbetween a −45° and 45° cephalad angle, terminating at needle orifice2038 located along the midline of the sensor array 2008, therebycontrolling the angle at which the needle is inserted into a human body.In some embodiments, the needle guide cartridge 2012 is oriented at a15° cephalad angle. In some embodiments, the needle guide cartridge 20122012 terminates at an opening. In some embodiments, the needle orifice2038 located on the center of the sensor array 2008 is an elongatedslit.

Fluid Collection System

In some embodiments, the system further comprises a fluid collectionsystem operatively connected to the tactile sensing device andconfigured to collect a fluid such as cerebrospinal fluid. In someembodiments, the fluid collection system is disposable. In someembodiments, the fluid collection system comprises a diaphragm, faucet,top faucet, spoke, or rail design. In some embodiments, the fluidcollection system is sterile. In some embodiments, the fluid collectionsystem is modular.

Pressure Sensor

In some embodiments, the system further comprises a pressure sensoroperatively connected to the tactile sensing device and configured tomeasure cerebrospinal fluid pressure. In some embodiments, the pressuresensor is operatively connected to the tactile sensing device via a3-way valve. In some embodiments, the pressure sensor is an electronicpressure sensor. In some instances, the pressure sensor is apiezoresistive, capacitive, electromagnetic, piezoelectric, optical, orpotentiometric pressure sensor. In some embodiments, cerebrospinal fluidpressure measured with the electronic pressure sensor is displayeddigitally. In some embodiments, cerebrospinal fluid pressure measuredwith the electronic pressure sensor is displayed on a display screen inreal-time.

Tactile Sensing Device: Uses

Disclosed herein, in certain embodiments, are methods for imaging boneand non-bone structures in an individual in need thereof, comprising:placing a tactile sensing device on the individual; applying force tothe tactile sensing device against the individual; and viewing an imageof bone and non-bone structures, obtained from voltage signals detectedby the tactile sensing device, resulting from the application of forceto the tactile sensing device against an individual, on a displayscreen. FIG. 4 exemplifies these methods for imaging bone and non-bonestructures in a flowchart. In some embodiments, the process to imagebone and non-bone structures with the tactile sensing device during alumbar puncture begins by having the user identify the midline of thepatient by moving the tactile sensing device laterally along thepatient's back until the midline is identified. In some embodiments, themidline of the patient is identified when the image of the bone andnon-bone structures shows the patient's spine centered on the displayscreen. In some embodiments, once the tactile sensing device iscorrectly aligned along the midline of the patient, the user ensuresforce is applied to the tactile sensing device and against the patient4078, in order to obtain the most accurate readings. In someembodiments, voltage signals is generated by the tactile sensing deviceand then collected 4080, as shown in FIG. 4. In some embodiments, thecollected voltage signals is processed by a computing device andtransformed into an image 4082, which the user visualizes 4084 on thedisplay screen.

Disclosed herein, in certain embodiments, are methods for generating animage of bone and non-bone structures in an individual in need thereof,comprising: collecting voltage signals detected by a tactile sensingdevice, resulting from the application of force to the tactile sensingdevice against an individual; converting the voltage signals into amathematical array; rescaling the mathematical array; and transformingthe rescaled mathematical array into an image of bone and non-bonestructures of the individual. In some embodiments, converting thevoltage signals comprises acquiring, processing, and transforming thesignals into the image using a computer processor. FIG. 10 exemplifiesthese methods for generating an image of bone and non-bone structures ina flowchart. In some embodiments, voltage signals generated by thetactile sensing device are transmitted via a multiplexer and a voltagedivider. In some embodiments, voltage signals generated by the tactilesensing device are transmitted via a voltage divider. In someembodiments, the transmitted voltage signals are collected using acomputer processor 10124. In some embodiments, the computer processorconverts the collected voltage signals into a mathematical array 10126.In some embodiments, the computer processor rescales the mathematicalarray 10128. In some embodiments, the rescaled mathematical array istransformed into an image 10130 that is displayed in real-time on thedisplay screen.

Bone and Non-Bone Structures

In some embodiments, the methods for imaging bone and non-bonestructures comprise imaging a first and second bone and non-bonestructures. In some embodiments, the methods for generating an image ofbone and non-bone structures comprise generating an image of a first andsecond bone and non-bone structures. In some embodiments, the methodsfor imaging bone and non-bone structures image a plurality of bone andnon-bone structures. In some embodiments, the methods for generating animage of bone and non-bone structures image a plurality of bone andnon-bone structures. In some embodiments, the methods for imaging boneand non-bone structures comprise placing the tactile sensing device onthe individual. In some embodiments, placing the tactile sensing deviceon the individual further comprises positioning the tactile sensingdevice on a bone structure. In some embodiments, a bone structure is arib. In some embodiments, a bone structure is an articular surface. Insome embodiments an articular surface is a vertebral articulation, anarticulation of a first bone of a hand with a second bone of the hand,an elbow joint, a wrist joint, an axillary articulation of a first boneof a shoulder with a second bone of the shoulder, a sternoclavicularjoint, a temporomandibular joint, a sacroiliac joint, a hip joint, aknee joint, or an articulations of a first bone of a foot with a secondbone of the foot. In some instances, a vertebral articulation is aspinous process. In some embodiments, a non-bone structure issubcutaneous tissue, a muscle, a ligament, adipose tissue, a cyst, or acavity.

Sensor Array

In some embodiments, the tactile sensing device 1000 comprises a sensorarray 1008. In some embodiments, the sensor array comprises tactilesensors. In some embodiments, the tactile sensors are force-sensitiveresistors. In some embodiments, the force-sensitive resistors changetheir resistive value in response to a change in applied pressure. Insome instances, the force-sensitive resistors output voltage signals. Insome embodiments, the array of force-sensitive resistors is a 6×3 arraycomprising eighteen force-sensitive resistors. In some embodiments, thearray of force-sensitive resistors is an 8×4 array comprising thirty twoforce-sensitive resistors. In some embodiments, the size of the array offorce-sensitive resistors is dependent upon the surface area of theindividual's body to be examined. In some embodiments, the array offorce-sensitive resistors is configured in a way that is sufficient tovisualize the bone and non-bone structures in the individual.

In some embodiments, as shown in FIGS. 3A and 3B, the array offorce-sensitive resistors is secured onto a sensor array platform 3022.In some embodiments, the sensor array platform 3022 comprisescylindrical struts 3026 onto which the force-sensitive resistors areadhered to. In some embodiments, the cylindrical struts 3026 onto whichthe force-sensitive resistors are adhered are connectors. In someembodiments, each sensor 3016 is covered with a material configured toenhance force feedback. In some embodiments, the material covering theforce-sensitive resistors is a hemispherical rubber disk.

Multiplexer

In some embodiments, the tactile sensing device further comprises amultiplexer. The multiplexer selects voltage output signals from theforce-sensitive resistors and forwards the selected voltage outputsignals into a single line. In some embodiments, the multiplexer ismounted onto a printed circuit board.

Voltage Divider

In some embodiments, the tactile sensing device further comprises avoltage divider. In some embodiments, the voltage signal output from theforce-sensitive resistors is read out using a voltage divider.

Pressure Map

In some embodiments, the image of bone and non-bone structures providedto the user via a display screen is a pressure map representing bone andnon-bone structures. In some embodiments, the pressure map is a heatmap. In some embodiments, the heat map is a graphical representation ofvoltage signals wherein the individual voltage output signals arerepresented as a plurality of colors, color hues, color saturations,graphical patterns, shading, geometrical figures, or any combinationthereof. In some embodiments, the pressure map is overlaid onto a secondimage.

Lumbar Puncture Methods

Disclosed herein, in certain embodiments, are methods for performing alumbar puncture in an individual in need thereof, comprising: placing atactile sensing device on a lumbar region of the individual; applyingforce to the tactile sensing device against the lumbar region; viewingvoltage signals, corresponding to vertebral articulations, detected bythe tactile sensing device resulting from the application of force tothe tactile sensing device against the lumbar region, on a displayscreen; localizing two spinous processes on the image; identifying a gapbetween a first spinous process and a second spinous process of theindividual; using a needle guide to insert a needle between the firstand second spinous processes of the individual and into a subarachnoidspace; and collecting cerebrospinal fluid or administering a therapeuticagent.

Epidural Methods

Disclosed herein, in certain embodiments, are methods for administeringa therapeutic agent to an epidural space of an individual in needthereof, comprising: placing a tactile sensing device on a lumbar regionof the individual; applying force to the tactile sensing device againstthe lumbar region; viewing voltage signals, corresponding to vertebralarticulations, detected by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion, on a display screen; localizing two spinous processes on theimage; identifying a gap between a first spinous process and a secondspinous process of the individual; using a needle guide to insert aneedle between the first and second spinous processes and into theepidural space of the individual; and injecting a therapeutic agent intothe epidural space.

Therapeutic Agents

In some embodiments, therapeutic agents are delivered via a lumbarpuncture. In some embodiments, therapeutic agents delivered via a lumbarpuncture include but are not limited to: anesthetics, analgesics,chemotherapeutic agents, contrast agents or dyes, anti-spasmodic agents,antibiotics, or proteins. In some embodiments, anesthetics delivered viaa lumbar puncture include but are not limited to: bupivacaine,lidocaine, tetracaine, procaine, ropivacaine, levobupivacaine,prilocaine, and cinchocaine. In some embodiments, analgesics deliveredvia a lumbar puncture include but are not limited to: opioids such asmorphine, fentanyl, diamorphine, buprenorphine, and pethidine ormeperidine; and non-opioids such as clonidine. In some embodiments,chemotherapeutic agents delivered via a lumbar puncture include but arenot limited to: methotrexate, cytarabine, hydrocortisone, and thiotepa.In some embodiments, contrast agents or dyes delivered via a lumbarpuncture include but are not limited to: iohexol, metrizamide,iopamidol, ioversol, iopromide, iodixanol, iolotran, andiodophenylundecylic acid. In some embodiments, anti-spasmodic agentsdelivered via a lumbar puncture include baclofen. In some embodiments,antibiotics delivered via a lumbar puncture include gentamicin sulphate.In some embodiments, proteins delivered via a lumbar puncture includeidursulfase.

Spinous Processes

In some embodiments, methods for performing a lumbar puncture in anindividual in need thereof comprise using a needle guide to insert aneedle between the first and second spinous processes and into thesubarachnoid space of the individual. In some embodiments, methods foradministering a therapeutic agent to an epidural space of an individualin need thereof comprise using a needle guide to insert a needle betweenthe first and second spinous processes and into the epidural space ofthe individual. In some embodiments, the first spinous process is a partof the first lumbar vertebra (L1), L2, L3, or L4 lumbar vertebrae andthe second spinous process is a part of L2, L3, L4, or L5 lumbarvertebrae. In some further embodiments, the first and spinous process isa part of any cervical, thoracic, lumbar, sacrum, or coccyx vertebrae.

Needles and Needle Guide

In some embodiments, the system further comprises a needle, a needleguide, a stylet, or a catheter. In some embodiments, the needle is anatraumatic, also known as pencil-point type needle, or a traumaticneedle, also known as a classic needle or a Quincke type needle. In someembodiments, the system further comprises a spinal needle. In someembodiments, the spinal needle is a Quincke spinal needle, a Whitacrespinal needle, or a Sprotte spinal needle. In some embodiments, thesystem further comprises an epidural needle. In some embodiments, theepidural needle is a Weiss epidural needle, a Tuohy epidural needle, ora Hustead epidural needle. In some embodiments, the needle incudes, byway of non-limiting examples, a 6-gauge needle, an 8-gauge needle, a13-gauge needle, a 15-gauge needle, a 17-gauge needle, an 18-gaugeneedle, a 19-gauge needle, a 20-gauge needle, a 21-gauge needle, a22-gauge needle, a 23-gauge needle, a 24-gauge needle, a 25-gaugeneedle, a 26-gauge needle, a 27-gauge needle, a 28-gauge needle, a29-gauge needle, a 30-gauge needle, a 31-gauge needle, and a 32-gaugeneedle. In some embodiments, the needle is a spinal needle rangingbetween 1-10 inches in length. In some embodiments, the needle containsa stylet, also known as an obturator or an introducer, which is a finewire, a slender probe, or a solid rod with a metal hub fitted to match aneedle's bevel. In diagnostic lumbar punctures, a stylet is withdrawnfrom the needle to allow cerebrospinal fluid to flow out from the spinalcanal and through the needle hub.

In some embodiments, the system further comprises a catheter. In someembodiments, the catheter is an epidural tunneled catheter, which isimplanted into the epidural space as a medication delivery port. In someembodiments, the catheter is used to monitor intracranial pressureduring a diagnostic lumbar puncture procedure. In some embodiments, thecatheter is used as means to continuously remove cerebrospinal fluid andrelieve pressure on the brain of a patient suffering from hydrocephalus.

In some embodiments, a needle guide 1002 is operatively connected to thetactile sensing device 1000. In some embodiments, the needle guide 1002,operatively connected to the tactile sensing device 1000, is used tocontrol the angle and direction of a needle that is inserted into anindividual in need thereof. In some embodiments, the needle guide 1002is oriented between a −45° and 45° cephalad angle, terminating at aneedle orifice 1038 located on the center of the sensor array 1008,thereby controlling the angle at which the needle is inserted into ahuman body. In some embodiments, the needle guide 1002 is oriented at a15° cephalad angle. In some embodiments, the needle orifice 1038 locatedon the center of the sensor array 1008 is an elongated slit. In someembodiments, the needle guide 1002 terminates at a plurality of openingsformed by an elongated slit with a plurality of columns. In variousfurther embodiments, as shown in FIGS. 2A, 2B, and 2C, a needle guidecartridge 2012 is operatively connected to the tactile sensing device2000. In some embodiments, the needle guide cartridge 2012 is orientedbetween a −45° and 45° cephalad angle, terminating at a needle orifice2038 located along the midline of the sensor array 2008, therebycontrolling the angle at which the needle is inserted into a human body.In some embodiments, the needle guide cartridge 2012 is oriented at a15° cephalad angle. In some embodiments, the needle guide cartridge 2012terminates at an opening. In some embodiments, the needle orifice 2038located on the center of the sensor array 2008 is an elongated slit.

Guiding Methods

Disclosed herein, in certain embodiments, are methods for guiding afirst individual performing a lumbar puncture on a second individual inneed thereof, comprising: placing a tactile sensing device on a lumbarregion of the individual; applying force to the tactile sensing deviceagainst the lumbar region; viewing voltage signals, corresponding tovertebral articulations, detected by the tactile sensing deviceresulting from the application of force to the tactile sensing deviceagainst the lumbar region, on a display screen; localizing two spinousprocesses on the image; identifying a gap between a first spinousprocess and a second spinous process of the individual; using a needleguide to insert a needle between the first and second spinous processesof the individual and into a subarachnoid space; and collectingcerebrospinal fluid or administering a therapeutic agent.

Disclosed herein, in certain embodiments, are methods for guiding afirst individual administering a therapeutic agent into an epiduralspace of a second individual in need thereof, comprising: placing atactile sensing device on a lumbar region of the individual; applyingforce to the tactile sensing device against the lumbar region; viewingvoltage signals, corresponding to vertebral articulations, detected bythe tactile sensing device resulting from the application of force tothe tactile sensing device against the lumbar region, on a displayscreen; localizing two spinous processes on the image; identifying a gapbetween a first spinous process and a second spinous process of theindividual; using a needle guide to insert a needle between the firstand second spinous processes and into the epidural space of theindividual; and injecting a therapeutic agent into the epidural space.

Tactile Sensing Device: Kits

Disclosed herein, in certain embodiments, are kits for performing adiagnostic lumbar puncture in an individual in need thereof, comprising:a tactile sensing device to image bone and non-bone structures in theindividual; a computer to process voltage signals detected by thetactile sensing device; a display screen to visualize the bone andnon-bone structures; an electronic pressure sensor to measurecerebrospinal fluid pressure; and a fluid collection system to collectcerebrospinal fluid.

Sensor Array

In some embodiments, the tactile sensing device 1000 comprises a sensorarray 1008. In some embodiments, the sensor array comprises a pluralityof tactile sensors. In some embodiments, the tactile sensors areforce-sensitive resistors. In some embodiments, the force-sensitiveresistors change their resistive value in response to a change inapplied pressure. In some instances, the force-sensitive resistorsoutput voltage signals. In some embodiments, the array offorce-sensitive resistors is a 6×3 array comprising eighteenforce-sensitive resistors. In some embodiments, the array offorce-sensitive resistors is an 8×4 array comprising thirty twoforce-sensitive resistors. In some embodiments, the size of the array offorce-sensitive resistors is dependent upon the surface area of theindividual's body to be examined. In some embodiments, the array offorce-sensitive resistors is configured in a way that is sufficient tovisualize the bone and non-bone structures in the individual. In someembodiments, as shown in FIGS. 3A and 3B, the array of force-sensitiveresistors is secured onto a sensor array platform 3022. In someembodiments, the sensor array platform 3022 comprises cylindrical struts3026 onto which the sensors are adhered to. In some embodiments, thecylindrical struts 3026 onto which the sensors are adhered areconnectors. In some embodiments, the force-sensitive resistors arecovered with a material configured to enhance force feedback. In someembodiments, the material covering the force-sensitive resistors is ahemispherical rubber disk.

Bone and Non-Bone Structures

In some embodiments, the tactile sensing device images a first andsecond bone and non-bone structures. In some embodiments, the tactilesensing device images a plurality of bone and non-bone structures. Insome embodiments, a bone structure is a rib. In some embodiments, a bonestructure is an articular surface. In some embodiments an articularsurface is a vertebral articulation, an articulation of a first bone ofa hand with a second bone of the hand, an elbow joint, a wrist joint, anaxillary articulation of a first bone of a shoulder with a second boneof the shoulder, a sternoclavicular joint, a temporomandibular joint, asacroiliac joint, a hip joint, a knee joint, or an articulations of afirst bone of a foot with a second bone of the foot. In some instances,a vertebral articulation is a spinous process. In some embodiments, anon-bone structure is subcutaneous tissue, a muscle, a ligament, adiposetissue, a cyst, or a cavity.

Computing Device

In some embodiments, the tactile sensing device further comprises acomputing device. In some embodiments, the computing device is amicrocontroller. In some embodiments, the microcontroller is an 8-bit,16-bit, or 32-bit microcontroller. In some embodiments, themicrocontroller is an 8051 microcontroller, a programmable interfacecontroller (PIC), an AVR or Advanced Virtual RISC microcontroller, or anARM® microcontroller. In some embodiments, the microcontroller is, byway of non-limiting examples, an Arduino Uno microcontroller or aRaspberry Pi microcontroller.

Display Screen

As shown in FIGS. 1A, 1B, 1C, 2A, 2B, and 2C, in some embodiments, thetactile sensing device 1000, 2000 comprises a display screen 1032, 2032to provide visual information to a user. In some embodiments, thedisplay screen 1032 is operatively connected to the tactile sensingdevice 1000. In some embodiments, the display screen 2032 is operativelyconnected to the tactile sensing device 2000. In some embodiments, thedisplay screen is a computer screen, a mobile device screen, or aportable device screen. In some embodiments, the display screen is acathode ray tube (CRT). In some embodiments, the display screen is aliquid crystal display (LCD). In further embodiments, the display screenis a thin film transistor liquid crystal display (TFT-LCD). In someembodiments, the display screen is an organic light emitting diode(OLED) display. In various further embodiments, an OLED display is apassive-matrix OLED (PMOLED) or active-matrix OLED (AMOLED) display. Insome embodiments, the display screen 1032, 2032 is a plasma display. Inother embodiments, the display screen is a video projector. In stillfurther embodiments, the display screen is a combination of devices suchas those disclosed herein.

In some embodiments, the visual information provided to the user via adisplay screen is a pressure map representing bone and non-bonestructures. In some embodiments, the pressure map is a heat map. In someembodiments, the heat map is a graphical representation of voltagesignals wherein the individual voltage output signals are represented asa plurality of colors, color hues, color saturations, graphicalpatterns, shading, geometrical figures, or any combination thereof.

Needle Guide

In some embodiments, as shown in FIGS. 1A, 1B, and 1C, a needle guide1002 is operatively connected to the tactile sensing device 1000. Insome embodiments, the needle guide 1002, operatively connected to thetactile sensing device 1000, is used to control the angle and directionof a needle that is inserted into an individual in need thereof. In someembodiments, the needle guide 1002 is oriented between a −45° and 45°cephalad angle, terminating at a needle orifice 1038 located on thecenter of the sensor array 1008, thereby controlling the angle at whichthe needle is inserted into a human body. In some embodiments, theneedle guide 1002 is oriented at a 15° cephalad angle. In someembodiments, the needle orifice 1038 located on the center of the sensorarray 1008 is an elongated slit. In some embodiments, the needle guide1002 terminates at a plurality of openings formed by an elongated slitwith a plurality of columns. In various further embodiments, as shown inFIGS. 2A, 2B, and 2C, a needle guide cartridge 2012 is operativelyconnected to the tactile sensing device 2000. In some embodiments, theneedle guide cartridge 2012 is oriented between a −45° and 45° cephaladangle, terminating at a needle orifice 2038 located along the midline ofthe sensor array 2008, thereby controlling the angle at which the needleis inserted into a human body. In some embodiments, the needle guidecartridge 2012 is oriented at a 15° cephalad angle. In some embodiments,the needle guide cartridge 2012 terminates at an opening. In someembodiments, the needle orifice 2038 located on the center of the sensorarray 2008 is an elongated slit.

Pressure Sensor

In some embodiments, the tactile sensing device further comprises apressure sensor operatively connected to the tactile sensing device andconfigured to measure cerebrospinal fluid pressure. In some embodiments,the pressure sensor is operatively connected to the tactile sensingdevice via a 3-way valve 2014. In some embodiments, the pressure sensoris an electronic pressure sensor. In some instances, the pressure sensoris a piezoresistive, capacitive, electromagnetic, piezoelectric,optical, or potentiometric pressure sensor. In some embodiments,cerebrospinal fluid pressure measured with the electronic pressuresensor is displayed digitally. In some embodiments, cerebrospinal fluidpressure measured with the electronic pressure sensor is displayed on adisplay screen in real-time.

Fluid Collection System

In some embodiments, the tactile sensing device further comprises afluid collection system operatively connected to the tactile sensingdevice and configured to collect a fluid such as cerebrospinal fluid. Insome embodiments, the fluid collection system is disposable. In someembodiments, the fluid collection system comprises a diaphragm, faucet,spoke, or rail design. In some embodiments, the fluid collection systemis sterile. In some embodiments, the fluid collection system is modular.

FIGS. 1A, 1B, and 1C show an illustration of one embodiment of thetactile sensing device 1000. The tactile sensing device 1000 comprises asensor array 1008, a display screen 1032, a needle guide 1002, and afaucet fluid collection system 1006. The tactile sensing device furthercomprises a handle 1004 in the shape of a pistol grip. The handle 1004is proximal to the user. The tactile sensing device 1000 is configuredto image a target tissue location and to guide a needle to a desiredtarget tissue location.

Sensor array 1008 is distal to the user. Sensor array 1008 comprises 18sensors; only a first sensor 1016 a, a second sensor 1016 b, a thirdsensor 1016 c, a fourth sensor 1016 d, a fifth sensor 1016 e, and asixth sensor 1016 f are shown in FIG. 1B. One additional row of sixsensors is found adjacent to the right of first sensor 1016 a, secondsensor 1016 b, third sensor 1016 c, fourth sensor 1016 d, fifth sensor1016 e, and sixth sensor 1016 f, and an additional row of six sensors isfound adjacent to the left of sensor first sensor 1016 a, second sensor1016 b, third sensor 1016 c, fourth sensor 1016 d, fifth sensor 1016 e,and sixth sensor 1016 f (not shown in FIGS. 1A, 1B, and 1C). In someembodiments, the sensor array 1008 is a tactile sensor array. In someembodiments, the sensor array 1008 is an ultrasound sensor array. Insome embodiments, the sensor array 1008 is an infrared radiation (IR)sensor array. Sensor array 1008 is a sensor array cartridge that ispressed into a sensor array holder 1104, which is located distally,beneath the display screen 1032. Sensors in the sensor array 1008 faceaway from the user when the sensor array 1008 is loaded into placewithin the tactile sensing device. In some embodiments, the sensor array1008 turns on once it is loaded into the sensor array holder 1104.Sensor array holder 1104 is loaded into place in a multitude of ways.Non-limiting examples of loading the sensor array 1008 into the sensorarray holder 1104 that are not shown in FIGS. 1A, 1B, and 1C, include:pressing the sensor array 1008 into the sensor array holder 1104,including snap fit features that allow the sensor array 1008 to stay inplace once loaded, any magnetic means to hold the sensor array 1008 inplace, any mechanical means to hold the sensor array 1008 in place. Insome embodiments, a tugging string is used to snap the sensor array 1008out of the sensor array holder 1104. In some embodiments the sensorarray 1008 comprises snap ledges, or other reversible means of loadingthe sensor array 1008 into the sensor array holder 1104. In someembodiments, the sensor array 1008 remains in place simply because itabuts the ledge of the sensor array holder 1104. In some embodiments,one or more tabs are present on the external surface of the sensor arrayholder 1104. The tabs are able to be twisted in order to preventunwanted movement or removal that is distally of the sensor array 1008relative to the sensor array holder 1104. In addition, the sensor array1008 is reversibly loaded into the sensor array holder 1104.

The sensors in the sensor array 1008 generate output voltage signalswhen the user applies a force using the tactile sensing device 1000 ontoa surface, for example, onto a tissue of a patient. The sensor array1008 is operatively connected to the display screen 1032 and a computingdevice (not shown in FIGS. 1A, 1B, and 1C). The sensor array 1008 relaysits output voltage signals to the computing device (not shown in FIGS.1A, 1B, and 1C), the computing device processes the output voltagesignals, and an image of the output voltage signals is visualized on thedisplay screen 1032.

The needle guide 1002 is shaped as a track, and it is configured toaccept a needle 1142. The needle guide 1002 includes a proximal opening1140 a and a distal opening 1140 b. In some embodiments, the needleguide 1002 is oriented at a 15° cephalad angle. In some embodiments, theneedle guide 1002 is oriented between a −45° and 45° cephalad angle. Theneedle 1142 is inserted into the needle guide 1002 through the proximalopening 1140 a and sits on the needle guide 1002. Once inserted into theneedle guide 1002, the needle 1142 exits the needle guide 1002 through aneedle orifice 1038 located in the sensor array 1008, between the thirdsensor 1016 c and the fourth sensor 1016 d.

A 3-way valve 1014 is inserted into the needle guide 1002 through thedistal slit 1090 b and sits on the needle guide 1002. In someembodiments, the 3-way valve 1014 is connected to a needle via itsneedle hub prior to insertion into the needle guide 1002. The 3-wayvalve 1014 is shown in the center of the needle guide 1002 in FIGS. 1Band 1C. The 3-way valve comprises a needle hub connector 1100, apressure gauge connector 1094, and a fluid port 1096. The needle hubconnector 1100 faces distally away from the user, and it is configuredto connect to a needle hub. The pressure gauge connector 1094 isoriented upward, and it is configured to connect to a pressure sensor(not shown in FIGS. 1A, 1B, and 1C). In some embodiments, the pressuregauge connector 1094 protrudes through the slit 1090. The fluid port1096 faces the user, and it is an open port through which fluid flowsfreely. The fluid port 1096 faces the user, and it is an open portthrough which fluid, collected from a patient, flows freely. First fluidhole 1098 a is located between the 3-way valve 1014 and the proximalneedle guide 1002 a. Second fluid hole 1098 b is located directlybeneath first fluid hole 1098 a. In some embodiments, cerebrospinalfluid (CSF) flows freely through the fluid port 1096, follows thedownward sloping needle guide 1002, flows through the first fluid hole1098 a, flows through the second fluid hole 1098 b, and flows into acollection tube 1010 a. In some embodiments, fluid collected from apatient flows freely through the fluid port 1096, follows the downwardsloping needle guide 1002, flows through the first fluid hole 1098 a,flows through the second fluid hole 1098 b, and flows into a collectiontube 1010 a.

In some embodiments, a knob (not shown in FIGS. 1A, 1B, and 1C) isoperatively connected to the 3-way valve 1014. In some embodiments, aknob (not shown in FIGS. 1A, 1B, and 1C) is operatively coupled to thetactile sensing device 1000. Non-liming examples of operativelyconnecting the knob (not shown in FIGS. 1A, 1B, and 1C) include:coupling the knob to the needle hub connector 1100, coupling the knob tothe pressure gauge connector 1094, coupling the knob to a pressure gauge(not shown in FIG. 1A, 1B, or 1C) connected to the pressure gaugeconnector 1094, or coupling the knob to a pressure sensor (not shown inFIG. 1A, 1B, or 1C) connected to the pressure gauge connector 1094. Theknob (not shown in FIG. 1A, 1B, or 1C) enables the needle to bereversibly moved towards the sensor array 1008 or away from the sensorarray 1008, once the needle 1142 is operatively coupled to the tactilesensing device 1000. The knob (not shown in FIG. 1A, 1B, or 1C)protrudes through the slit 1090 and may be displaced through the lengthof the slit. In some embodiments, the knob (not shown in FIG. 1A, 1B, or1C) protrudes through the proximal slit 1090 a when the needle 1142 hasnot been inserted into a patient. In some embodiments, the knob (notshown in FIG. 1A, 1B, or 1C) protrudes through the distal slit 1090 b orclose to the distal slit 1090 b when the user has inserted or is in theprocess of inserting the needle 1142 into a patient. The direction ofthe needle movement 1136 is shown in FIG. 1B.

The faucet fluid collection system 1006 comprises a central rod 1116, afaucet base 1054, a rotating handle 1052, and collection tubes 1010. Thefaucet base 1054 includes an elongated central rod 1116 extendingupwardly therefrom. The faucet base 1054 is located directly above, andit is operatively connected to the rotating handle 1052 via a projection1132. The rotating handle 1052 is able to be rotated clockwise orcounterclockwise about an imaginary Y-axis that vertically traverses thecentral rod 1116. Rotating the rotating handle 1052 enables rotation ofthe collection tubes 1010. The collection tubes 1010 sit on the faucetbase 1054. In some embodiments, the faucet base 1054 comprisesindividual round receptacles (not shown in FIGS. 1A, 1B, and 1C) thathold and provide support for collections tubes 1010. Collection tubes1010 comprise a first collection tube 1010 a, a second collection tube1010 b, and a third collection tube 1010 c, as shown in FIG. 1B. In someembodiments, the faucet fluid collection system 1006 comprises at leastone collection tube. In some embodiments, the faucet fluid collectionsystem comprises up to 20 collection tubes. The position of collectiontubes 1010 is controlled by the rotation of the rotating handle 1052.Collection tubes 1010 are positioned directly beneath the second fluidhole 1098 b when collecting a fluid.

In use, the tactile sensing device 1000 is turned on by the user via theinsertion of the sensor array 1008 into the sensor array holder 1114.The user holds the tactile sensing device by the handle 1004 and pressesthe sensor array 1008 against the patient. The user visualizesunderlying bone and/or soft tissue on the display screen 1032. The userinserts a needle into the needle guide 1002 and connects the needle tothe 3-way valve 1014 via a needle hub connector 1100. Based on the imageon the display screen 1032, the user is able to guide the needle at a15° cephalad angle into a desired target location in the patient. Insome embodiments, the user utilizes the tactile sensing device 1000 toperform a lumbar puncture to collect cerebrospinal fluid (CSF).Collection of CSF is facilitated by the faucet fluid collection system1006. Further non-limiting examples of fluid collections systems areillustrated in FIGS. 5-8. Once the needle reaches the subarachnoidspace, CSF begins to flow from the subarachnoid space, into the needle,through the needle hub, into the needle hub connector 1100, through the3-way valve 1014, through the fluid port 1096, through the first fluidhole 1098 a, through the second fluid hole 1098 b, and finally into afirst collection tube 1010 a. The user optionally monitors the CSFpressure in real time once the needle is in the subarachnoid space byconnecting a pressure sensor (not shown in FIGS. 1A, 1B, and 1C) to the3-way valve 1014 via a pressure gauge connector 1094.

FIGS. 2A, 2B, and 2C illustrate another embodiment of the tactilesensing device 2000. The tactile sensing device 2000 comprises a sensorarray 2008, a display screen 2032, a needle guide cartridge 2012, and arail fluid collection system 2062. The tactile sensing device furthercomprises a gripper 2020 with a curved shape. The gripper 2020 isproximal to the user. The tactile sensing device 2000 is configured toimage a target tissue location and to guide a needle to a desired targettissue location. The tactile sensing device 2000 further enablespositioning of a needle at five discrete levels. The tactile sensingdevice 2000 further enables positioning of a needle at a 15° cephaladangle; this angle is not accurately shown in FIGS. 2A, 2B, and 2C.

Sensor array 2008 is distal to the user. Sensor array 2008 comprises 18sensors: a first sensor 2016 a, a second sensor 2016 b, a third sensor2016 c, a fourth sensor 2016 d, a fifth sensor 2016 e, a sixth sensor2016 f, a seventh sensor 2016 g, an eighth sensor 2016 h, a ninth sensor2016 i, a tenth sensor 2016 j, an eleventh sensor 2016 k, a twelfthsensor 2016 l, a thirteenth sensor 2016 m, a fourteenth sensor 2016 n,an fifteenth sensor 2016 o, a sixteenth sensor 2016 p, a seventeenthsensor 2016 q, and an eighteenth sensor 2016 r are shown in FIG. 2B. Insome embodiments, the sensor array 2008 is a tactile sensor array.Sensor array 2008 is a sensor array cartridge that is loaded into asensor array holder 2104, which is located distally, beneath the displayscreen 2032. Sensors in the sensor array 2008 face away from the userwhen the sensor array 2008 is loaded into place. In some embodiments,the sensor array 2008 turns on once it is loaded into the sensor arrayholder 2104. The sensor array 2008 is loaded in a multitude of ways,including all the non-limiting examples of loading sensor array 1008mentioned supra. The sensors in the sensor array 2008 generate outputvoltage signals when the user applies a force using the tactile sensingdevice 2000 onto a surface, for example, onto a tissue of a patient. Thesensor array 2008 is operatively connected to the display screen 2032and a computing device (not shown in FIGS. 2A, 2B, and 2C). The sensorarray 2008 relays its output voltage signals to the computing device(not shown in FIGS. 2A, 2B, and 2C), the computing device processes theoutput voltage signals, and an image of the output voltage signals isvisualized on the display screen 2032.

The needle guide cartridge 2012 is a modular component. In someembodiments, the needle guide cartridge 2012 is disposable. In someembodiments, the needle guide cartridge 2012 is loaded into place. Theneedle guide cartridge 2012 comprises a first needle guide 2002 a, asecond needle guide 2002 b, a third needle guide 2002 c, a fourth needleguide 2002 d, and a fifth needle guide 2002 e. The needle guides areshaped like tracks and are configured to accept a needle (needle is notshown in FIGS. 2A, 2B, and 2C). A needle is placed on the needle guideby introducing it from the top, using either a proximal slit 2190 a, adistal slit 2190 b, a knob opening 2110, or a combination thereof. Insome embodiments, a needle is placed on the needle guide by introducingit through a first side opening 2106 a, a second side opening 2106 b, athird side opening 2106 c, a fourth side opening 2106 d, or a fifth sideopening 2106 e. The needle guides are oriented at a 15° cephalad angle.Once inserted into a needle guide, the needle (not shown in FIGS. 2A,2B, and 2C) exits the needle guide through a needle orifice located inthe sensor array 2008. A needle inserted into the first needle guide2002 a exits the sensor array 2008 through the first needle orifice 2038a located in the sensor array 2008. A needle inserted into the secondneedle guide 2002 b exits the sensor array 2008 through the secondneedle orifice 2038 b located in the sensor array 2008. A needleinserted into the third needle guide 2002 c exits the sensor array 2008through the third needle orifice 2038 c located in the sensor array2008. A needle inserted into the fourth needle guide 2002 d exits thesensor array 2008 through the fourth needle orifice 2038 d located inthe sensor array 2008. A needle inserted into the fifth needle guide2002 e exits the sensor array 2008 through the fifth needle orifice 2038e located in the sensor array 2008.

A 3-way valve 2014 is fixed to the needle guide cartridge 2012, belowthe fifth side opening 2106 e, and in between the guide rails 2134. The3-way valve comprises a needle hub connector 2100, a pressure gauge port2108, and a fluid connector 2068. The needle hub connector 2100 facesdistally away from the user, and it is configured to connect to tubingthat further connects to a needle hub (tubing and needle not shown inFIGS. 2A, 2B, and 2C). The pressure gauge port 2108 is oriented awayfrom the needle guide cartridge 2012. The pressure gauge port 2108 isconfigured to connect to a pressure sensor (not shown in FIGS. 2A, 2B,and 2C). The fluid connector 2068 is configured to connect to tubing.The fluid connector 2068 comprises an opening that is oriented downwardin order to lead a fluid into a collection tube. For example, FIG. 2Bshows the fluid connector 2068 protruding into a third collection tube2010 c.

The rail fluid collection system 2062 comprises a sliding rail platform2064 and collection tubes. For example, the rail fluid collection system2062 includes a first collection tube 2010 a, a second collection tube2010 b, a third collection tube 2010 c, and a fourth collection tube2010 d. Two guide rails 2134 extend beneath the needle guide cartridge2012 and receive two longitudinal edges of the sliding rail platform2064. The sliding rail platform 2064 includes rail platform openings2132. In some embodiments, the rail platform openings 2132 are circularin shape. The rail platform openings 2132 are configured to holdcollection tubes. The position of collection tubes 1010 is controlled bythe sliding of rail platform 2064 along the guide rails 2134. Collectiontubes 1010 are positioned directly beneath the fluid connector 2068 whencollecting a fluid.

FIGS. 3A and 3B illustrate a sensor array 3008. In particular, FIG. 3Billustrates the application of the sensor array 3008 onto artificiallumbar vertebrae 3030. The sensor array 3008 comprises a sensor arrayplatform 3022 that is rectangular in shape. The sensor array platform3022 comprises a 6×3 array of cylindrical struts 3026 that protrude fromthe surface of the sensor array platform. In some embodiments, thecylindrical struts 3026 are 5 mm in diameter. In some embodiments, thecenter-to-center distance between the cylindrical struts 3026 is 11 mm.Each sensor 3016 is adhered onto the top surface of the cylindricalstruts 3026. A hemispherical disk 3024 is secured above each adheredsensor 3016. The hemispherical disk 3024 enhances force feedback to eachsensor 3016. In some embodiments, the hemispherical disk 3024 iscomposed of a compressible material. In some embodiments, thehemispherical disk 3024 is composed of a plastic that is soft andpliable at room temperature. In some embodiments, the hemispherical disk3024 is composed of rubber. In some embodiments, the hemispherical disk3024 is composed of silicone. In some embodiments, the hemisphericaldisk 3024 is composed of polyethylene. In some embodiments, thehemispherical disk 3024 is composed of a plastic that is hard andnon-pliable at room temperature. In some embodiments, the hemisphericaldisk 3024 is composed of polystyrene. Non-limiting examples of materialsthat are used to fabricate the hemispherical disk 3024 include:polypropylene, polyester, polycarbonate, polyvinyl chloride, nylon,poly(methyl methacrylate), polyethylene terephthalate, polyimide, orBakelite.

FIG. 4 shows a method of using a tactile sensing device to obtain animage. In a step 4078, the tactile sensing device is pressed against anarea that is to be imaged and force is applied to the sensor array ofthe tactile sensing device. In a step 4080, a computing device isprovided, and the computing device is operatively connected to thetactile sensing device. The computing device collects voltage signalsthat are generated by the sensor array of the tactile sensing deviceafter a force is applied onto the surface of the sensors in the sensorarray. In a step 4082, the computing device processes the collectedvoltage signals such that the voltage signals are converted into animage. In a step 4084, the image is displayed on a display screen of thetactile sensing device. In some embodiments, the image displayed is aheat map. In some embodiments, the image displayed provides the userfeedback regarding the uniformity of their application of force to thetactile sensing device. In some embodiments, the image displayedincludes the approximate position of a needle at the skin surface aswell as the approximate depth of a needle. In some embodiments, forexample, when the tactile sensing device comprises multiple needleguides as the exemplary embodiment shown in FIGS. 2A, 2B, and 2C, theimage displayed includes the approximate positions and depths at alllevels corresponding with the multiple needle guides.

FIG. 5 illustrates a flow control diaphragm fluid collection system5042. The diaphragm fluid collection system 5042 is amenable to beincorporated into the tactile sensing device. The diaphragm fluidcollection system 5042 includes a first collection tube 5010 a, a secondcollection tube 5010 b, a third collection tube 5010 c, and a fourthcollection tube 5010 d. The collection tubes are stacked vertically, oneon top of the other. The first collection tube 5010 a is located on topof the second collection tube 5010 b, which is located on top of thethird collection tube 5010 c, which is located on top of the fourthcollection tube 5010 d. A cap 5046 is configured to be secured on thefirst collection tube 5010 a. Non-limiting examples of configurations tosecure the cap 5046 onto the first collection tube 5010 a include:threading, snap-fitting into the collection tube's circumference,snap-fitting into a slot, and snug-fitting. The first collection tube5010 a is connected to the second collection tube. The first collectiontube 5010 a has a first diaphragm 5044 a instead of a bottom flatsurface. A first rotating band 5112 a allows the first diaphragm 5044 ato be opened by rotating the first rotating band 5112 acounterclockwise. In some embodiments, the first rotating band 5112 aallows the first diaphragm 5044 a to be opened by rotating the firstrotating band 5112 a clockwise. A first rotating band 5112 a allows thefirst diaphragm 5044 a to be closed by rotating the first rotating band5112 a clockwise. In some embodiments, the first rotating band 5112 aallows the first diaphragm 5044 a to be closed by rotating the firstrotating band 5112 a counterclockwise. When the first diaphragm 5044 ais opened, fluid is able to flow through the first aperture 5114 a. Thesecond collection tube 5010 b includes a second diaphragm 5044 b and asecond rotating band 5112 b that controls the opening and closing of thesecond diaphragm 5044 b in the same manner as the first collection tube5010 a set up. Similarly, the third collection tube 5010 c includes athird diaphragm 5044 c and a third rotating band 5112 c that controlsthe opening and closing of the third diaphragm 5044 c in the same manneras already described. The fourth collection tube 5010 d does notcomprise a diaphragm. When the first diaphragm 5044 a, the seconddiaphragm 5044 b, and the third diaphragm 5044 c are open, fluid flowsthrough the first aperture 5114 a, the second aperture 5114 b, and thethird aperture 5114 c and collects inside the fourth collection tube5010 d. In this manner, the user is able to control which collectiontube the fluid is to be collected in.

In some embodiments, the diaphragm fluid collection system 5042comprises at least two collection tubes. In some embodiments, thediaphragm fluid collection system 5042 comprises three collection tubes.In some embodiments, the diaphragm fluid collection system 5042comprises four collection tubes. In some embodiments, the diaphragmfluid collection system 5042 comprises five collection tubes. In someembodiments, the diaphragm fluid collection system 5042 comprises sixcollection tubes. In some embodiments, the diaphragm fluid collectionsystem 5042 comprises seven collection tubes. In some embodiments, thediaphragm fluid collection system 5042 comprises eight collection tubes.In some embodiments, the diaphragm fluid collection system 5042comprises nine collection tubes. In some embodiments, the diaphragmfluid collection system 5042 comprises ten collection tubes. In someembodiments, the diaphragm fluid collection system 5042 comprisesbetween ten and fifteen collection tubes. In some embodiments, thediaphragm fluid collection system 5042 comprises between fifteen andtwenty collection tubes.

FIG. 6 illustrates a top faucet fluid collection system 6120. In the topfaucet fluid collection system 6120, a faucet element or rotating handle6052 is operatively connected to housing 6118 that serves also as a capto a container 6056. In some embodiments, a faucet element or rotatinghandle 6052 is placed at the bottom of a faucet base 6054 (thisembodiment is now shown in FIG. 6), similar to the faucet fluidcollection system 1006 of FIGS. 1A, 1B, and 1C. The rotating handle 6052enables the collection tubes to be rotated clockwise or counterclockwiseabout an imaginary Y-axis that vertically traverses the center of thecontainer 6056. The rotating handle 6052 is reversibly connected to acentral rod 6116. The central rod 6116 is permanently connected to thefaucet base 6054. Thus, when the central rod 6116 is attached to therotating handle 6052 and the rotating handle 6052 is rotated, therotational movement of the rotating handle 6052 enables the simultaneousrotation of the central rod 6116 and the faucet base 6054.

The container 6056 holds a plurality of collection tubes. In FIG. 6,there are a total of four collection tubes, but only a first collectiontube 6010 a and a second collection tube 6010 b are clearly depicted.The housing 6118 is reversibly connected to the container 6056.Non-limiting examples of configurations to reversibly secure the housing6118 onto the container 6056 include: threading, snap-fitting into thecollection tube's circumference, snap-fitting into a slot, orsnug-fitting. In some embodiments, the collection tubes are reversiblysecured to the bottom of the container 6056. In some embodiments, thecollection tubes are reversibly secured to the faucet base 6054. Theuser detaches the container 6056 from the housing 6118 and disconnectsthe central rod 6116 from the rotating handle 6052, in order to accessthe collection tubes inside the container 6056.

A circular plate is found within the housing 6118 (not shown in FIG. 6),lying parallel to the rotating handle 6052. The circular plate (notshown in FIG. 6) has a single orifice located directly beneath thefaucet connector 6050. The faucet connector 6050 extends outwardly fromthe housing 6118 and is perpendicular to the container 6056. The faucetconnector 6050 is configured to connect to a needle hub or tubing. Fluidtraveling from a needle hub or from tubing and through the faucetconnector 6050 flows through an elbow hollow opening (not shown in FIG.6) that aligns with the orifice in the circular plate, the fluid exitsthe orifice in the circular plate (not shown in FIG. 6), and flows intoone of the collection tubes inside the container. The collection tubesare rotated clockwise or counterclockwise to allow for sequentialfilling. In some embodiments, the housing 6118 has numbers or labels toindicate the position of a collection tube. In some embodiments, therotating handle 6052 has numbers or labels to indicate the position of acollection tube.

FIG. 7 illustrates a spoke fluid collection system 7058. The spoke fluidcollection system 7058 comprises a central hub 7060, which is octagonalin shape. The central hub 7060 includes a first central hub opening 7086a, a second central hub opening 7086 b, a third central hub opening 7086c, and a fourth central hub opening 7086 d. Each central hub opening islocated on a side surface of the central hub 7060. For example, FIG. 7illustrates the third central hub opening 7086 c is located on the thirdside surface 7102 c and the fourth central hub opening 7086 d is locatedon the fourth side surface 7102 d. The first central hub opening 7086 aand the second central hub opening 7086 b are also located on sidesurfaces, however, these side surfaces are not shown in FIG. 7. Thefirst central hub opening 7086 a is configured to connect to a firstcollection tube 7010 a. The second central hub opening 7086 b isconfigured to connect to a second collection tube 7010 b. The thirdcentral hub opening 7086 c is configured to connect to a thirdcollection tube 7010 c. The fourth central hub opening 7086 d isconfigured to connect to a fourth collection tube 7010 d. Non-limitingexamples of configurations to connect the collection tubes to thecentral hub openings include: threading, snap-fitting into thecollection tube's circumference, snap-fitting into a slot, orsnug-fitting. The central hub 7060 has a front face 7092 that is planar.A spoke connector 7088 extends outwardly from the front face 7092 and isperpendicular to an imaginary Y-axis vertically traversing the centralhub 7060 through the center of the first collection tube 7010 a andthrough the center of the third collection tube 7010 c. The spokeconnector 7088 is configured to connect to a needle hub, tubing, or a3-way valve. The spoke connector 7088 is hollow inside and serves as achannel to transport fluid. The interior (not shown in FIG. 7) of thecentral hub 7060 is completely sealed except for openings that coincidewith the central hub openings. In addition, the central hub 7060comprises a solid inner ring-like structure (not shown in FIG. 7)located in the interior of the central hub 7060. The solid innerring-like structure (not shown in FIG. 7) has a single orifice thataligns with the first collection tube 7010 a. Fluid flowing through thespoke connector 7088 exits the spoke connector 7088 and falls at a 90°angle into the orifice of the solid inner ring-like structure. Thus, anyfluid flowing through the spoke connector 7088 only accumulates in acollection tube that is in the position of the first collection tube7010 a shown in FIG. 7.

Secured to the back face (not shown in FIG. 7) of the central hub 7060is a knob (not shown in FIG. 7) that allows for the rotation of thecentral hub 7060 about an imaginary Z-axis that traverses the centralhub 7060 through its center, perpendicular to the first collection tube7010 a and the third collection tube 7010 c. The knob (not shown in FIG.7) is rotated clockwise or counterclockwise. The rotation of the centralhub 7060 by the knob (not shown in FIG. 7) enables the collection tubesto be rotated about the imaginary Z-axis when attached to the centralhub 7060. In some embodiments, the knob (not shown in FIG. 7) hasnumbers or labels to indicate the position of a collection tube.

FIG. 8 illustrates a rail fluid collection system 8062. The rail fluidcollection system 8062 comprises a sliding rail platform 8064, a firstcollection tube 8010 a, a second collection tube 8010 b, a thirdcollection tube 8010 c, a fourth collection tube 8010 d, and guide rails8134. The guide rails 8134 receive two longitudinal edges of the slidingrail platform 8064. The sliding rail platform 8064 includes railplatform openings 8132. In some embodiments, the rail platform openings8132 are circular in shape. The rail platform openings 8132 areconfigured to hold collection tubes. The lip 8122 of the collection tubeprojects onto the rail platform 8064. The position of the collectiontubes is controlled by a manual sliding motion 8138 of the rail platform8064 along the guide rails 8134. The collection tubes are positioneddirectly beneath a 3-way valve 8014 when they are to collect fluid.

The function of the 3-way valve 8014 is to direct fluid from an externalneedle hub or tubing into a collection tube. The 3-way valve 8014includes a fluid connector 8068, which protrudes from the bottom surfaceof the 3-way valve 8014. The 3-way valve also includes a needle hubconnector 8100, which protrudes outwardly from the 3-way valve 8014 andis perpendicular to the fluid connector 8100. The needle hub connector8100 is configured to connect to an external needle hub or tubing. Afluid flowing from an external needle hub or tubing, through the needlehub connector 8100, flows downward at a 90° angle through the fluidconnector 8068 when exiting the needle hub connector 8100, andsubsequently flows into a first collection tube 8010 a. The fluidconnector 8068 is configured to connect to tubing. In some embodiments,the fluid connector 8068 is optionally connected to tubing instead ofonly openly protruding into a collection tube. Another function of the3-way valve 8014 is to enable a pressure sensor to obtain a pressuremeasurement of the fluid that is in contact with the 3-way valve 8014.The 3-way valve 8014 includes a pressure gauge port 8108 facing awayfrom the guide rails 8134. The pressure gauge port 8108 is configured toconnect to a pressure sensor.

FIGS. 9A and 9B are exemplary data demonstrating the functionality ofthe tactile sensing device on a lumbar spine model. Recordings areacquired using a combination of signal acquisition and processingexecuted by a computing device. In some embodiments, the computingdevice further comprises a non-transitory computer readable storagemedium with a computer program including instructions executable by aprocessor. In some embodiments, the computer program is written inPython code, Arduino code, or a combination thereof. FIG. 9Ademonstrates the change in voltage across a single sensor when moved in1 cm increments, with changes in applied force. The applied force variesbased on a mass. FIG. 9A shows the mass, and thus the applied force,varies between 20 g to 500 g. The bolded horizontal lines represent theunderlying spinous processes 9070. Voltage increases are apparent forsensors that are situated above these underlying spinous processes 9070.FIG. 9B demonstrates the change in voltage across a tactile sensingdevice comprising a column of 6 sensors with a 1 cm center-to-centerdistance. Voltages across each sensor are shown in FIG. 9B for 6 trials.In each trial, the column of 6 sensors is moved 1 cm increments. Anincrease in voltage is apparent for sensors above the underlying spinousprocesses 9070 (denoted as “bone” in FIG. 9B) throughout the 6 trials.

FIG. 10 is a flow chart describing the instructions included in acomputer program, which are executable by a computing device. In someembodiments, a sensor array comprising at least one sensor is configuredto output a signal in response to a change in force applied to itssurface; wherein the signal is converted to a pressure map. Step 1 10124describes the output voltage signals generated by the force-sensitiveresistors via a voltage divider are inputted into the computing devicevia a multiplexer. Step 2 10126 describes the inputted voltage signalsare written to a serial monitor. In some embodiments, step 2 10126further comprises organizing the inputted voltage signals. In someembodiments, a first computer program that includes instructionsexecutable by a processor performs step 2 10126. In some embodiments,the instructions to perform step 2 10126, which are included in thecomputer program are written in Arduino programming language. In step 310128, a second computer program includes instructions to acquire theinputted voltage signals that were written to the serial monitor andgenerates a 6×3 array of sensor data. In some embodiments, theinstructions to perform step 3 10128, which are included in the secondcomputer program are executable by a processor. In step 4 10130, asecond computer program includes instructions to process the inputtedvoltage signals that were written to the serial monitor and rescales thepreviously generated 6×3 array of sensor data to a 60×30 array of sensordata. In some embodiments, the instructions to perform step 4 10130 usecubic interpolation methods to rescale the array of sensor data. In someembodiments, the instructions to perform step 4 10130, which areincluded in the second computer program are executable by a processor.In step 5 10132, a second computer program includes instructions toupdate the display for real-time target tissue visualization. In someembodiments, the instructions to perform step 3 10128, step 4 10130, andstep 5 10132, which are included in the second computer program arewritten in Python programming language. In some embodiments, the displayis updated for real-time visualization of a patient's spine. Thus, FIG.10 illustrates the process of transforming sensor output into a visualdisplay. In some embodiments, the visual display is a pressure map.

In some embodiments, the algorithm shown in FIG. 10 is used to generatea pressure map. In some embodiments, the pressure map is a heat map. Insome embodiments, the heat map displays high voltages in a red color. Insome embodiments, high voltages are at or near 5V, corresponding togreater applied force. In some embodiments, high voltages in a heat mapcorrespond to a bone. In some embodiments, high voltages in a heat mapcorrespond to spinous processes. In some embodiments, the heat mapdisplays low voltages in a blue color. In some embodiments, low voltagesin a heat map correspond to tissue softer than bone. In someembodiments, low voltages in a heat map correspond to inter interspinousligaments.

FIG. 11A illustrates a representative image of a pressure-mappingoutput. In some embodiments, the pressure map 11046 visually representsa target tissue location in an individual. In some embodiments, apressure map 11046 is generated using the algorithm shown in FIG. 10. Insome embodiments, the pressure map 11046 shown in FIG. 11A is generatedby using the tactile sensing device on an obese model of the lumbarspine. In some embodiments, a representation of the setup for using thetactile-sensing array applied to an obese model of the lumbar spine isshown in FIG. 3B. In some embodiments, the tactile sensing device,comprising the sensor array, is pressed lightly against the lumbar spinemodel; the 2nd and 5th midline sensors are positioned directly over thespinous processes. In some embodiments, a third computer program, whichincludes instructions to display the voltage signals sensed at a 1stmidline sensor 11016 a, a 2nd midline sensor 11016 b, a 3rd midlinesensor 11016 c, a 4th midline sensor 11016 d, a 5th midline sensor 11016e, and a 6th midline sensor 11016 f along the midline (column 2 of thesensor array) after interpolation, was added to the algorithm describedin FIG. 10. In some embodiments, the pressure map 11046 is generatedusing the algorithm as described in FIG. 10 and the third computerprogram described supra. In some embodiments, the voltage values 11042,which are shown in FIG. 11A, range between about 0V and about 5V. Insome embodiments, high voltage values are shown in a color red. In someembodiments, low voltage values are shown in a color blue. As shown inFIG. 11A, the greatest force, as evidenced by higher voltages, is foundover the 2nd midline sensor 11016 b and 5th midline sensor 11016 e,which correspond to bony landmarks. In addition to revealing the gapbetween spinous processes, this visualization is also useful inproviding feedback to the user on the uniformity of their forceapplication. For example, it is clear in this pressure map 11046 thatthe user's force is slightly biased toward the sensors on the right.Therefore, the pressure map 11046 indicates to the user that the forcethat they are applying onto the tactile sensing device needs to bebetter distributed or corrected.

FIG. 11B illustrates a pressure map 11046 showing the needle's positionat the skin level (“original”), and its adjusted, projected location,accounting for the remaining depth of the subcutaneous fat. In someembodiments, the pressure map 11046 only displays the needle position atthe skin level 11048. In some embodiments, the pressure map 11046 onlydisplays the projected position of the needle 11050, adjusted for theremaining depth of the subcutaneous fat. In some embodiments, thepressure map 11046 shown in FIG. 11B is generated by using the tactilesensing device on a lumbar spine model.

In some embodiments, a trigonometric algorithm, as shown in Equation 2below, is used to determine the depth level at which the needle will beonce it traverses the subcutaneous fat. Equation 2: h=tan(θ)*d; whereinwhere h is the adjustment level; d refers to the tissue depth; and θ isthe cephalad angle at which the needle is inserted.In some embodiments, the depth used in this equation is experimentallydetermined to robustly apply to lumbar spine models with a wide spectrumof body mass indexes (BMIs): provided that the user applies significantforce to overcome the damping in the underlying fat layers, theremaining depth to the spinous process becomes fairly uniform acrosscases.

In some embodiments, the depth level at which the needle will be once ittraverses the subcutaneous fat is calculated proportionally. In someembodiments, the depth level at which the needle will be once ittraverses the subcutaneous fat is calculated based on calculating theratio between the maximum voltage reading (for example, over a spinousprocess) and the minimum voltage reading (for example, over aninterspinous ligament) for the midline sensors and comparing this ratioto an empirically determined ratio of the maximum voltage reading to theminimum voltage reading. In some embodiments, the empirically determinedratio of the maximum voltage reading to the minimum voltage reading isdetermined based on a known depth.

In some embodiments, the depth level at which the needle will be once ittraverses the subcutaneous fat is calculated based on machine-learningalgorithms. In some embodiments, machine-learning algorithms enhance theaccuracy of the displayed needle projection.

In some embodiments, the tactile sensing device further comprises amarking tool. The marking tool helps the user identify the tissue targetlocation. In some embodiments, the marking tool enables the user to markthe entry point of a needle on the skin surface of the patient. In someembodiments, the marking tool enables the user to mark or label a tissuetarget location. In some embodiments, marking or labeling the tissuetarget location is done subcutaneously, intramuscularly, or on the skinsurface. In some embodiments, the marked tissue location is detected bya medical imaging device. In some embodiments, the marking tool enablesthe user to mark or label a target tissue location in order to beidentified by a medical imaging device or system. In some embodiments,the marking tool is a light, an ink, a hydrogel, a nanoparticle. In someembodiments, the light is a laser light or a light emitting diode (LED).In some embodiments, the ink is a permanent ink, a gentian violent ink,a water-based ink, an oil-based in, a liquid ink, or a gel ink. In someembodiments, the hydrogel further comprises a contrast agent. In someembodiments, the nanoparticle further comprises a contrast agent. Insome embodiments, the contrast agent includes, but is not limited to: amagnetic contrast agent, a radiocontrast agent, a radioactive contrastagent, a magnetic resonance imaging contrast agent, and a microbubblecontrast agent. Non-limiting examples of the magnetic contrast agentinclude: gadolinium-based agents or nanoparticles, iron oxide-basedagents or nanoparticles, iron platinum-based agents or nanoparticles,and manganese-based agents or nanoparticles. Non-limiting examples ofthe radiocontrast agent include: iodine-based agents or nanoparticles,air, thorium dioxide, carbon dioxide, gastrografin, and barium-basedagents or nanoparticles. Non-limiting examples of the radioactivecontrast agent include: ⁶⁴Cu diacetyl-bis(N⁴-methylthiosemicarbazone),also called ATSM or Copper 64, ¹⁸F-fluorodeoxyglucose (FDG),¹⁸F-fluoride, 3′-deoxy-3′[¹⁸F]fluorothymidine (FLT),¹⁸F-fluoromisonidazole, gallium, techtenium-99m, and thallium.

EXAMPLES Example 1: Tactile Sensing Device Prototype Testing in a LumbarSpine Model

Select data is presented here to demonstrate the functionality of thetactile sensing device 1000 on an artificial lumbar spine model 3028, asshown in FIG. 3B. Recordings were acquired using a combination of signalacquisition and processing in a computing device. FIG. 9A illustratesthe change in voltage across a single sensor when moved in 1 centimeterincrements, with changes in applied force 9076. The bolded horizontallines 9070 represent the underlying artificial spinous processes 3030;voltage increases 9072 are apparent for sensors that are situated abovethese artificial spinous processes. Detected voltage values are thelowest 9074 when there are no artificial spinous processes present belowthe tactile sensing device 1000. FIG. 9B exemplifies a column of 6sensors with 1 centimeter center-to-center distance was designed.Voltages across each sensor were recorded for 6 trials, moving thecolumn 1 centimeter each time. Again, an increase in voltage 9072 isapparent for sensors above the artificial spinous processes 3030(denoted as ‘bone’ and illustrated by the bolded horizontal lines 9070on FIG. 9B). Results presented by FIG. 9B demonstrate the detection ofartificial bone using the tactile sensing device was accurate andconsistent across all six trials.

Example 2: Diagnostic Lumbar Puncture Using a Tactile Sensing Device

A health care worker performing a lumbar puncture on an obese subjectplaces the tactile sensing device on the lumbar region of the subject. Apressure map, viewed as a heat map by the health care worker, appears onthe display screen 1032, 2032 of the tactile sensing device 1000, 2000.The heat map indicates bone structures, in this case spinous processesof the lumbar vertebrae, by representing these in red color base andindicates non-bone structures by representing these in a blue colorbase. The tactile sensing device simultaneously computes a needleprojection and displays it on the pressure map. The health care workeradjusts the tactile sensing device's needle guide angle to a cephaladangle degree between −45° and 45°. After identifying a gap between twoof the lumbar vertebrae, for example L2 and L3, the health care workerinserts a spinal needle into the tactile sensing device's needle guide.The health care worker uses the needle guide and the needle projectionand heat map on the screen to guide the needle into the subarachnoidspace. The health care worker then uses the tactile sensing device's1000 modular fluid collection system 1006 to collect cerebrospinal fluid(CSF). Once all CSF samples are collected, the health care worker usesthe tactile sensing device's 1000 electronic pressure sensor, whichautomatically displays the CSF pressure CSF flow is detected, to readoutand record the subject's intracranial pressure.

Example 3: Epidural Administration of a Therapeutic Using a TactileSensing Device

A health care worker performing an epidural administration of ananesthetic on a pregnant patient to places the tactile sensing device onthe lumbar region of the pregnant patient. A pressure map, viewed as aheat map by the health care worker, appears on the display screen 1032,2032 of the tactile sensing device 1000, 2000. The heat map indicatesbone structures, in this case spinous processes of the lumbar vertebrae,by representing these in red color base and indicates non-bonestructures by representing these in a blue color base. The tactilesensing device simultaneously computes a needle projection and displaysit on the pressure map. The health care worker adjusts the tactilesensing device's needle guide angle to a cephalad angle degree between−45° and 45°. After identifying a gap between two of the lumbarvertebrae, for example L2 and L3, the health care worker inserts aspinal needle into the tactile sensing device's needle guide. The healthcare worker uses the needle guide and the needle projection and heat mapon the screen to guide the needle into the epidural space and inject theanesthetic.

Example 4: Synovial Cavity Injection Using a Tactile Sensing Device

A health care worker administering a hyaluronan injection, such asSynvisc-One®, to the knee joint of a patient suffering fromosteoarthritis uses the tactile sensing device, instead of thetraditional palpation and pen marking approach, to correctly localizeneedle placement. Correct needle placement is crucial in order to avoidaccidentally jabbing the knee's cartilage and eliciting further damage.The health care worker places the tactile sensing device 1000, 2000 onthe patient's knee. A pressure map, viewed as a heat map by the healthcare worker, appears on the display screen 1032, 2032 of the tactilesensing device 1000, 2000. The heat map indicates bone structures, inthis case the patella, femur and tibia, by representing these in a redcolor base. The heat map indicates non-bone structures, in this case thebursae of the knee, by representing these in a blue color base. Thetactile sensing device 1000, 2000 simultaneously computes a needleprojection and displays it on the pressure map. The health care workeradjusts the tactile sensing device's 1000, 2000 needle guide angle to acephalad angle degree between −45° and 45°. After identifying thesuprapatellar bursa, the health care worker inserts a needle into thetactile sensing device's 1000, 2000 needle guide. The health care workeruses the needle guide and the needle projection and heat map on thescreen to guide the needle into the suprapatellar bursa and injecthyaluronan.

What is claimed is:
 1. A tactile sensing device for imaging a targettissue location in an individual in need thereof, comprising: a) aneedle guide having a proximal opening and a distal opening, configuredfor guiding a needle towards the individual; and b) a sensor arraycomprising at least one sensor configured to detect applied pressure. 2.A tactile sensing device for imaging a target tissue location in anindividual in need thereof, comprising: a) a needle guide cartridgecomprising at least two needle guides, wherein each needle guide has aside opening and a distal opening, and each needle guide is configuredfor guiding a needle towards the individual; and b) a sensor arraycomprising at least one sensor configured to detect applied pressure. 3.A tactile sensing device for imaging a target tissue location in anindividual in need thereof, comprising: a) a sensor array comprising atleast one sensor configured to detect applied pressure; b) a displayscreen; and c) a marking tool to mark the target tissue location.
 4. Atactile sensing device for imaging a target tissue location in anindividual in need thereof, comprising: a) a sensor array comprising atleast one sensor configured to detect applied pressure; b) a connectionto a display screen; and c) a marking tool to mark the target tissuelocation.
 5. The tactile sensing device of claim 2, wherein the needleguide cartridge allows for the needle to be inserted into the individualat more than one level.
 6. The tactile sensing device of any of claims1-4, and wherein the needle guide allows for the needle to be insertedinto the individual at more than one angle.
 7. The tactile sensingdevice of claim 6, wherein the angle is a cephalad angle between about−45 degrees to about 45 degrees.
 8. The tactile sensing device of claim7, wherein the angle is a 15 degree cephalad angle.
 9. The tactilesensing device of any one of claims 1-4, wherein the sensor array isconfigured to be loaded into a sensor array holder.
 10. The tactilesensing device of any one of claims 1-4, further comprising a frame. 11.The tactile sensing device of claim 10, wherein the frame furthercomprises an elongated portion carrying the needle guide, a downwardlyelbowed portion serving as a handle, and a sensor array holderpositioned distally away from the handle.
 12. The tactile sensing deviceof any one of claims 1-2, further comprising a display screen positioneddirectly above the sensor array.
 13. The tactile sensing device of anyone of claim 3, 4, or 12, wherein the display screen is configured todisplay the target tissue location and the needle to be inserted intothe individual.
 14. The tactile sensing device of any one of claim 3, 4,or 12, wherein the display screen is a computer screen, a mobile devicescreen, a liquid crystal display (LCD), a thin film transistor liquidcrystal display (TFT-LCD), or an organic light emitting diode (OLED)display.
 15. The tactile sensing device of any one of claims 1-4,further comprising a needle hub connector that connects to the needle,configured to be inserted through an opening of the needle guide. 16.The tactile sensing device of claim 15, wherein the opening of theneedle guide is the proximal opening of the needle guide or a knobopening of the needle guide.
 17. The tactile sensing device of any oneof claims 1-4, further comprising a knob that is coupled to a needle hubconnector or extends from a needle hub connector.
 18. The tactilesensing device of claim 17, wherein the knob protrudes from a sideopening or a slit.
 19. The tactile sensing device of any one of claims1-4, further comprising a valve.
 20. The tactile sensing device of claim19, wherein the valve is a 3-way valve or a 3-way stopcock valve. 21.The tactile sensing device of claim 19, wherein the valve is configuredto be inserted through a knob opening of a needle guide.
 22. The tactilesensing device of claim 19, wherein the valve is fixed onto a needleguide cartridge.
 23. The tactile sensing device of claim 19, wherein thevalve further comprises a needle hub connector, a fluid connector, afluid port, a pressure gauge connector, a pressure gauge port, or acombination thereof.
 24. The tactile sensing device of any one of claims1-4, further comprising a fluid collection system.
 25. The tactilesensing device of claim 24, wherein the fluid collection system is afaucet fluid collection system, rail fluid collection system, diaphragmfluid collection system, or spoke fluid collection system.
 26. Thetactile sensing device of claim 25, wherein the faucet fluid collectionsystem comprises at least one collection tube, a central rod extendingdownwardly from a frame, a faucet base extending downwardly from thecentral rod, and a rotating handle for generating a rotational movement,said rotating handle coupled to the faucet base, wherein at least onecollection tube sits on the faucet base.
 27. The tactile sensing deviceof claim 25, wherein the rail fluid collection system comprises a pairof guide rails extending beneath a needle guide cartridge, said guiderails configured to receive a sliding rail platform, said rail platformcomprising at least one opening, said opening configured to hold atleast one collection tube.
 28. The tactile sensing device of claim 25,wherein the diaphragm fluid collection system comprises at least onecollection tube, at least one diaphragm, at least one rotating bandallowing the diaphragm to be opened or closed, and a cap configured tobe secured onto a first collection tube.
 29. The tactile sensing deviceof claim 25, wherein the spoke fluid collection system comprises acentral hub; at least one central hub opening located on a side surfaceof the central hub, said central hub opening configured to connect to atleast one collection tube; and a spoke connector extending outwardlyfrom a front face of the central hub.
 30. The tactile sensing device ofany one of claims 1-4, wherein the needle is a spinal needle, anepidural needle, or a biopsy needle.
 31. The tactile sensing device ofany one of claims 1-4, wherein the sensor array is a 6×3 sensor arraycomprising eighteen sensors.
 32. The tactile sensing device of any oneof claims 1-4, wherein the sensor array is an 8×4 array comprisingthirty two sensors.
 33. The tactile sensing device of any one of claims1-4, wherein the sensor array is secured onto a platform.
 34. Thetactile sensing device of claim 33, wherein the platform comprisesprojections onto which the sensors are adhered to.
 35. The tactilesensing device of claim 34, wherein the projections are struts orconnectors.
 36. The tactile sensing device of any one of claims 1-4,wherein the sensor is covered with a material configured to enhanceforce feedback.
 37. The tactile sensing device of any one of claims31-36, wherein the sensor is a force-sensitive resistor.
 38. The tactilesensing device of any one of claims 3-4, wherein the marking tool is alight, an ink, a hydrogel, a nanoparticle.
 39. The tactile sensingdevice of claim 38, wherein the light is a laser light or a lightemitting diode (LED).
 40. The tactile sensing device of claim 38,wherein the ink is a permanent ink, a gentian violent ink, a water-basedink, an oil-based in, a liquid ink, or a gel ink.
 41. The tactilesensing device of claim 38, wherein the hydrogel further comprises acontrast agent.
 42. The tactile sensing device of claim 38, wherein thenanoparticle further comprises a contrast agent.
 43. The tactile sensingdevice of any one of claims 1-4, further comprising a multiplexer. 44.The tactile sensing device of any one of claims 1-4, further comprisinga voltage divider.
 45. The tactile sensing device of any one of claims1-4, further comprising a voltage source.
 46. The tactile sensing deviceof any one of claims 1-4, further comprising a pressure sensoroperatively connected to the tactile sensing device and configured tomeasure an intracranial pressure.
 47. The tactile sensing device ofclaim 46, wherein the pressure sensor is a piezoresistive pressuresensor, a capacitive pressure sensor, an electromagnetic pressuresensor, a piezoelectric pressure sensor, an optical pressure sensor, ora potentiometric pressure sensor.
 48. A system for imaging a targettissue location in an individual in need thereof, comprising: a) atactile sensing device of any one of claims 1-47; and b) a computingdevice comprising: i) at least one processor operatively coupled to thetactile sensing device; ii) a memory device; and iii) a non-transitorycomputer readable storage medium with a computer program includinginstructions executable by the processor causing the processor toconvert a voltage signal into an image.
 49. The system of claim 48,wherein the computing device is a microcontroller.
 50. The system ofclaim 48, wherein the computing device further comprises a secondcomputer program including instructions executable by the processor thatcause the processor to encode the voltage signal into a first computersignal and a second computer signal.
 51. The system of claim 50, furthercomprising a transmitter configured to transmit the first computersignal to the computing device.
 52. The system of claim 50, furthercomprising a receiver configured to receive the second computer signalfrom the tactile sensing device.
 53. The system of claim 50, wherein thefirst and second computer signals are transmitted remotely, directly,wirelessly, or via a wire.
 54. The system of claim 50, wherein the firstcomputer signal and the second computer signals are wireless signals.55. The system of claim 48, wherein the computing device is a mobiledevice.
 56. The system of claim 50, wherein the computing device furthercomprises a third computer program including instructions executable bythe processor that cause the processor to calculate a projected needleposition and display it on the display screen.
 57. The system of claim56, wherein the computing device further comprises a fourth computerprogram including instructions executable by the processor causing theprocessor to: a) determine, as a first requirement, a location of atarget tissue location detected by the tactile sensing device; and b)perform predictive analysis based on application of machine learning toapproximate the projected needle position.
 58. A method for imaging atarget tissue location in an individual in need thereof, comprising: a)placing a tactile sensing device of any one of claims 1-47 on theindividual; b) applying force to the tactile sensing device against theindividual; and c) viewing an image of the target tissue location,obtained from voltage signals generated by the tactile sensing device,resulting from the application of force to the tactile sensing deviceagainst an individual, on a display screen.
 59. A method for generatingan image of a target tissue location in an individual in need thereof,comprising: a) collecting a plurality of voltage signals generated by atactile sensing device of any one of claims 1-47, resulting from theapplication of force to the tactile sensing device against anindividual; b) converting the voltage signals into a mathematical array;c) rescaling the mathematical array; and d) transforming the rescaledmathematical array into the image of a target tissue location of theindividual.
 60. The method of any one of claim 58 or 59, wherein thetarget tissue location is a bone structure.
 61. The method of claim 60,wherein the bone structure is an articular surface.
 62. The method ofclaim 61, wherein the articular surface is a vertebral articulation, anarticulation of a first bone of a hand with a second bone of the hand,an elbow joint, a wrist joint, an axillary articulation of a first boneof a shoulder with a second bone of the shoulder, a sternoclavicularjoint, a temporomandibular joint, a sacroiliac joint, a hip joint, aknee joint, or an articulation of a first bone of a foot with a secondbone of the foot.
 63. The method of claim 62, wherein a vertebralarticulation is a spinous process.
 64. The method of any one of claim 58or 59, wherein the target tissue location is a subcutaneous tissue, amuscle, a ligament, an adipose tissue, a cyst, a cavity, or a tumormass.
 65. The method of claim 58, wherein placing the tactile sensingdevice on the individual further comprises positioning the tactilesensing device on a bone structure.
 66. The method of claim 65, whereinthe bone structure is a vertebral column of an individual.
 67. Themethod of claim 59, wherein collecting the plurality of voltage signalsfurther comprises transmitting the data via a multiplexer.
 68. Themethod of claim 59, wherein collecting the plurality of the voltagesignals further comprises transmitting the data via a voltage divider.69. The method of claim 59, wherein converting the plurality of thevoltage signals comprises acquiring, processing, and transforming theplurality of voltage signals into the image using a computer processor.70. The method of claim 69, wherein the image is a pressure maprepresenting the target tissue location.
 71. The method of claim 70,wherein the pressure map is overlaid on top of a structural spinalimage.
 72. A method for performing a lumbar puncture in an individual inneed thereof, comprising: a) placing a tactile sensing device of any oneof claims 1-47 on a lumbar region of the individual; b) applying forceto the tactile sensing device against the lumbar region; c) viewing animage of vertebral articulations on a display screen; wherein the imageis generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes of the individual and into asubarachnoid space; and g) collecting cerebrospinal fluid oradministering a therapeutic agent.
 73. The method of claim 72, whereinthe therapeutic agent is an analgesic, an anesthetic, a chemotherapeuticagent, or a contrast agent or dye.
 74. A method for administering atherapeutic agent to an epidural space of an individual in need thereof,comprising: a) placing a tactile sensing device of any one of claims1-47 on a lumbar region of the individual; b) applying force to thetactile sensing device against the lumbar region; c) viewing an image ofvertebral articulations on a display screen; wherein the image isdetected by the tactile sensing device resulting from the application offorce to the tactile sensing device against the lumbar region; d)localizing two spinous processes on the image; e) identifying a gapbetween a first spinous process and a second spinous process of theindividual; f) using a needle guide to insert a needle between the firstand second spinous processes and into the epidural space of theindividual; and g) injecting a therapeutic agent into the epiduralspace.
 75. The method of claim 74, wherein the therapeutic agent is ananalgesic, an anesthetic, a contrast agent or dye, a chemotherapeuticagent, or a steroid.
 76. The method of any one of claim 72 or 74,wherein the first spinous process is a part of L1, L2, L3, or L4 lumbarvertebrae and the second spinous process is a part of L2, L3, L4, or L5lumbar vertebrae.
 77. The method of any one of claim 72 or 74, whereinthe needle is a traumatic or an atraumatic needle.
 78. The method of anyone of claim 72 or 74, further comprising using a stylet or a catheterin conjunction with the needle.
 79. A method for guiding a firstindividual performing a lumbar puncture on a second individual in needthereof, comprising: a) placing a tactile sensing device of any one ofclaims 1-47 on a lumbar region of the individual; b) applying force tothe tactile sensing device against the lumbar region; c) viewing animage of vertebral articulations on a display screen, wherein the imageis generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes of the individual and into asubarachnoid space; and g) collecting cerebrospinal fluid oradministering a therapeutic agent.
 80. A method for guiding a firstindividual administering a therapeutic agent into an epidural space of asecond individual in need thereof, comprising: a) placing a tactilesensing device of any one of claims 1-47 on a lumbar region of theindividual; b) applying force to the tactile sensing device against thelumbar region; c) viewing an image of vertebral articulations on adisplay screen, wherein the image is generated by the tactile sensingdevice resulting from the application of force to the tactile sensingdevice against the lumbar region; d) localizing two spinous processes onthe image; e) identifying a gap between a first spinous process and asecond spinous process of the individual; f) using a needle guide toinsert a needle between the first and second spinous processes and intothe epidural space of the individual; and g) injecting a therapeuticagent into the epidural space.
 81. A method for imaging a target tissuelocation in an individual in need thereof, comprising: a) placing atactile sensing device on the individual; b) applying force to thetactile sensing device against the individual; and c) viewing an imageof the target tissue location, obtained from voltage signals generatedby the tactile sensing device, resulting from the application of forceto the tactile sensing device against an individual, on a displayscreen.
 82. A method for generating an image of a target tissue locationin an individual in need thereof, comprising: a) collecting a pluralityof voltage signals generated by a tactile sensing device, resulting fromthe application of force to the tactile sensing device against anindividual; b) converting the voltage signals into a mathematical array;c) rescaling the mathematical array; and d) transforming the rescaledmathematical array into the image of a target tissue location of theindividual.
 83. The method of any one of claim 81 or 82, wherein thetarget tissue location is a bone structure.
 84. The method of claim 83,wherein the bone structure is an articular surface.
 85. The method ofclaim 84, wherein the articular surface is a vertebral articulation, anarticulation of a first bone of a hand with a second bone of the hand,an elbow joint, a wrist joint, an axillary articulation of a first boneof a shoulder with a second bone of the shoulder, a sternoclavicularjoint, a temporomandibular joint, a sacroiliac joint, a hip joint, aknee joint, or an articulation of a first bone of a foot with a secondbone of the foot.
 86. The method of claim 85, wherein a vertebralarticulation is a spinous process.
 87. The method of any one of claim 81or 82, wherein the target tissue location is a subcutaneous tissue, amuscle, a ligament, an adipose tissue, a cyst, a cavity, or a tumormass.
 88. The method of claim 81, wherein placing the tactile sensingdevice on the individual further comprises positioning the tactilesensing device on a bone structure.
 89. The method of claim 88, whereinthe bone structure is a vertebral column of an individual.
 90. Themethod of any one of claim 81 or 82, wherein the tactile sensing devicecomprises an array of force-sensitive resistors.
 91. The method of claim90, wherein the array of force-sensitive resistors is a 6×3 arraycomprising eighteen force-sensitive resistors.
 92. The method of claim90, wherein the array of force-sensitive resistors is an 8×4 arraycomprising thirty two force-sensitive resistors.
 93. The method of claim90, wherein the array of force-sensitive resistors is secured onto aplatform.
 94. The method of claim 93, wherein the platform comprisesprojections onto which the force-sensitive resistors are adhered to. 95.The method of claim 94, wherein the projections are struts orconnectors.
 96. The method of claim 95, wherein the force-sensitiveresistors are covered with a material configured to enhance forcefeedback.
 97. The method of claim 96, wherein the material configured toenhance force feedback is a hemispherical rubber disk.
 98. The method ofclaim 82, wherein collecting the plurality of voltage signals furthercomprises transmitting the data via a multiplexer.
 99. The method ofclaim 82, wherein collecting the plurality of the voltage signalsfurther comprises transmitting the data via a voltage divider.
 100. Themethod of claim 82, wherein converting the plurality of the voltagesignals comprises acquiring, processing, and transforming the pluralityof voltage signals into the image using a computer processor.
 101. Themethod of claim 100, wherein the image is a pressure map representingthe target tissue location.
 102. The method of claim 101, wherein thepressure map is overlaid on top of a structural spinal image.
 103. Amethod for performing a lumbar puncture in an individual in needthereof, comprising: a) placing a tactile sensing device on a lumbarregion of the individual; b) applying force to the tactile sensingdevice against the lumbar region; c) viewing an image of vertebralarticulations on a display screen; wherein the image is generated by thetactile sensing device resulting from the application of force to thetactile sensing device against the lumbar region; d) localizing twospinous processes on the image; e) identifying a gap between a firstspinous process and a second spinous process of the individual; f) usinga needle guide to insert a needle between the first and second spinousprocesses of the individual and into a subarachnoid space; and g)collecting cerebrospinal fluid or administering a therapeutic agent.104. The method of 103, wherein the therapeutic agent is an analgesic,an anesthetic, a chemotherapeutic agent, or a contrast agent or dye.105. A method for administering a therapeutic agent to an epidural spaceof an individual in need thereof, comprising: a) placing a tactilesensing device on a lumbar region of the individual; b) applying forceto the tactile sensing device against the lumbar region; c) viewing animage of vertebral articulations on a display screen; wherein the imageis detected by the tactile sensing device resulting from the applicationof force to the tactile sensing device against the lumbar region; d)localizing two spinous processes on the image; e) identifying a gapbetween a first spinous process and a second spinous process of theindividual; f) using a needle guide to insert a needle between the firstand second spinous processes and into the epidural space of theindividual; and g) injecting a therapeutic agent into the epiduralspace.
 106. The method of claim 105, wherein the therapeutic agent is ananalgesic, an anesthetic, a contrast agent or dye, a chemotherapeuticagent, or a steroid.
 107. The method of any one of claims 103 and 105,wherein the first spinous process is a part of L1, L2, L3, or L4 lumbarvertebrae and the second spinous process is a part of L2, L3, L4, or L5lumbar vertebrae.
 108. The method of any one of claims 103 and 105,wherein the needle is a traumatic or an atraumatic needle.
 109. Themethod of any one of claims 103 and 105, further comprising using astylet or a catheter in conjunction with the needle.
 110. The method ofany one of claims 103 and 105, wherein the needle guide is orientedbetween −45° and 45° cephalad angle and terminating at an openinglocated on the center of the tactile sensing device, thereby controllingthe angle at which the needle is inserted into a human body.
 111. Themethod of claim 110, wherein the opening located on the center of thetactile sensing device is an elongated slit.
 112. The method of any oneof claims 103 and 105, wherein the needle guide is oriented at a 15°cephalad angle.
 113. The method of any one of claims 103 and 105,wherein the needle guide terminates at a plurality of openings formed byan elongated slit with a plurality of columns.
 114. The method of anyone of claims 103 and 105, further comprising using a plurality ofneedle guides oriented between a −45° and 45° cephalad angle andterminating at a plurality of openings located along the midline of thetactile sensing device, thereby controlling the angle at which theneedle is inserted into a human body.
 115. The method of any one ofclaims 103 and 105, further comprising using a plurality of needleguides oriented at a 15° cephalad angle.
 116. The method of claim 115,wherein the plurality of needle guides terminates at an opening. 117.The method of claim 116, wherein the opening is an elongated slit. 118.A method for guiding a first individual performing a lumbar puncture ona second individual in need thereof, comprising: a) placing a tactilesensing device on a lumbar region of the individual; b) applying forceto the tactile sensing device against the lumbar region; c) viewing animage of vertebral articulations on a display screen, wherein the imageis generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes of the individual and into asubarachnoid space; and g) collecting cerebrospinal fluid oradministering a therapeutic agent.
 119. A method for guiding a firstindividual administering a therapeutic agent into an epidural space of asecond individual in need thereof, comprising: a) placing a tactilesensing device on a lumbar region of the individual; b) applying forceto the tactile sensing device against the lumbar region; c) viewing animage of vertebral articulations on a display screen, wherein the imageis generated by the tactile sensing device resulting from theapplication of force to the tactile sensing device against the lumbarregion; d) localizing two spinous processes on the image; e) identifyinga gap between a first spinous process and a second spinous process ofthe individual; f) using a needle guide to insert a needle between thefirst and second spinous processes and into the epidural space of theindividual; and g) injecting a therapeutic agent into the epiduralspace.